Advertisement

Prognosis of Initial CNS Involvement in Acute Lymphoblastic Leukemia Childhood

  • W. Dörffel
  • F. Zintl
  • H. Malke
  • G. Reuter
  • M. Reimann
Conference paper
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 33)

Abstract

The introduction of an effective prophylaxis of the CNS involvement represented great progress in the treatment of acute lympho-blastic leukemia (ALL), since until some years ago CNS involvement was considered to be incurable once it became manifest. In the Berlin-Frankfurt-Miinster BFM-ALL studies isolated CNS relapses occur relatively seldomly, but manifestation of a CNS-leukemia by the time of diagnosis is still considered a risk factor for subsequent relapses [1]. We analyzed the prognosis of the initial CNS involvement in 41 children from four multicenter ALL therapy studies of our Arbeitsgemeinschaft fur Padiatrische Hamatologie und Onkologie of the GDR. In the GDR-ALL-VII (81) study, which is a slightly modified ALL-BFM 81-protocol, we also investigated the patients’ characteristics with an initial CNS involvement in compar-ison with the total group of patients of this study in order to discover associations with other risk factors. Finally, we tried to find out whether the signs of the initial CNS manifestation are important for the progno-sis. The question for the prognostic risk of a “smoldering” meningeal leukemia was of special interest, i.e., the findings of leukemic blasts in the CSF without elevation of the CSF cell count.

Keywords

Bone Marrow Relapse Meningeal Leukemia Cranial Nerve Paresis Elevated Cell Count Lymphoblastic Leukemia Childhood 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Schrappe M, Beck J, Brandeis WE, Feickert H-J, Gadner H, Graf N, Havers W, Henze G, Jobke A, Kornhuber B, Kiihl J, Lampert F, Miiller-Weihrich S, Niethammer D, Reiter A, Rister M, Ritter J, Schellong G, Tausch W, Weinel P, Riehm H (1987) Die Behandlung der akuten lymphoblastischen Leukamie im Kindes- und Jugendalter: Ergebnisse der multizentrischen Therapiestudie ALL-BFM 81. Klin Padiatr 199: 133–150PubMedCrossRefGoogle Scholar
  2. 2.
    Sayk J (1960) Cytologie der Cerebrospinal-flussigkeit. Fischer, JenaGoogle Scholar
  3. 3.
    Zintl F, Plenert W, Blau H-J, Breidenbach H, Dorffel W, Exadaktylos P, Fuchs D, Grabner H, Hermnn J, Hofmann K, Moebius D, Mittler U, Reiners B, Ronisch P, Weinmann G, Zastrow J (1980) Die akute lymphatische Leukamie des Kindesalters — Therapie und Ergebnisse. Kinderarztl Praxis 48: 514–526Google Scholar
  4. 4.
    Dorffel W, Reuter G, Schontube M, Doring E, Grulich M, Richter D, Selle B, Schmitz H-H (1984) Akute lymphatische Leukamien im Kindesalter — aktuelle Aspekte der Diagnostik und Therapie. Dtsch Gesundheitswes 39: 662–666Google Scholar
  5. 5.
    Kaplan EL, Meier P (1958) Non-parametric estimation from incomplete observation. J Am Stat Assoc 53: 457–481CrossRefGoogle Scholar
  6. 6.
    Langermann H-J, Henze G, Wulf M, Riehm H (1982) Abschatzung der Tumorzellmasse bei der akuten lymphoblastischen Leukamie im Kindesalter: prognostische Bedeutung und praktische Anwendung. Klin Padiatr 194: 209–213PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • W. Dörffel
    • 1
  • F. Zintl
    • 2
  • H. Malke
    • 2
  • G. Reuter
    • 1
  • M. Reimann
    • 2
  1. 1.II. Dept. of PediatricsHospital Berlin-BuchGermany
  2. 2.Dept. of PediatricsFriedrich-Schiller-UniversityJenaGermany

Personalised recommendations