Treatment of acute lymphocytic leukemia in Down syndrome
Despite improvements in the prognosis of acute myelogenous leukemia in patients with Down syndrome, the prognosis of acute lymphocytic leukemia (DS-ALL) in these patients is still poorer than that of ALL in the general population. We compared treatment results between 4 patients with DS-ALL and 16 n...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2017-01-01
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| Series: | Cogent Medicine |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/2331205X.2017.1304512 |
| _version_ | 1811227989781774336 |
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| author | Yuki Gemma Fumio Bessho Hiroshi Yoshino |
| author_facet | Yuki Gemma Fumio Bessho Hiroshi Yoshino |
| author_sort | Yuki Gemma |
| collection | DOAJ |
| description | Despite improvements in the prognosis of acute myelogenous leukemia in patients with Down syndrome, the prognosis of acute lymphocytic leukemia (DS-ALL) in these patients is still poorer than that of ALL in the general population. We compared treatment results between 4 patients with DS-ALL and 16 non-Down syndrome patients with ALL (NDS-ALL). Four patients with DS-ALL treated with TCCSG protocols achieved complete remission by the end of the induction phase. During the high-dose methotrexate (HD-MTX) phase, the dosage of MTX was reduced from 3 to 2 g/m2 after the syndrome of inappropriate ADH secretion developed in the first patient. All DS-ALL patients had severe mucositis and a longer period of anorexia than NDS-ALL patients, even after dose reductions, resulting in a longer HD-MTX phase in DS-ALL patients than in NDS-ALL patients. The mean dosages of 6-MP and MTX during the maintenance phase were significantly lower in DS-ALL patients than in NDS-ALL patients (6-MP 22.1 ± 9.9 mg/m2 and MTX 16.1 ± 4.5 mg/m2 vs. 6-MP 43.5 ± 23.1 mg/m2 and MTX 25.2 ± 8.8 mg/m2, respectively). All DS-ALL patients have been in complete remission for a median of 10 years 0 month (range: 8 years 10 months-14 years 1 month) as of January 1, 2017. DS-ALL patients may receive the same treatment protocol as that for NDS-ALL patients with adequate care and few modifications, and this strategy may result in the expansion of treatment protocols suitable for DS-ALL patients in the future. |
| first_indexed | 2024-04-12T09:50:58Z |
| format | Article |
| id | doaj.art-78af6af80205407b84c6b26b33788f46 |
| institution | Directory Open Access Journal |
| issn | 2331-205X |
| language | English |
| last_indexed | 2024-04-12T09:50:58Z |
| publishDate | 2017-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Cogent Medicine |
| spelling | doaj.art-78af6af80205407b84c6b26b33788f462022-12-22T03:37:50ZengTaylor & Francis GroupCogent Medicine2331-205X2017-01-014110.1080/2331205X.2017.13045121304512Treatment of acute lymphocytic leukemia in Down syndromeYuki Gemma0Fumio Bessho1Hiroshi Yoshino2Kyorin University School of MedicineKyorin University School of MedicineKyorin University School of MedicineDespite improvements in the prognosis of acute myelogenous leukemia in patients with Down syndrome, the prognosis of acute lymphocytic leukemia (DS-ALL) in these patients is still poorer than that of ALL in the general population. We compared treatment results between 4 patients with DS-ALL and 16 non-Down syndrome patients with ALL (NDS-ALL). Four patients with DS-ALL treated with TCCSG protocols achieved complete remission by the end of the induction phase. During the high-dose methotrexate (HD-MTX) phase, the dosage of MTX was reduced from 3 to 2 g/m2 after the syndrome of inappropriate ADH secretion developed in the first patient. All DS-ALL patients had severe mucositis and a longer period of anorexia than NDS-ALL patients, even after dose reductions, resulting in a longer HD-MTX phase in DS-ALL patients than in NDS-ALL patients. The mean dosages of 6-MP and MTX during the maintenance phase were significantly lower in DS-ALL patients than in NDS-ALL patients (6-MP 22.1 ± 9.9 mg/m2 and MTX 16.1 ± 4.5 mg/m2 vs. 6-MP 43.5 ± 23.1 mg/m2 and MTX 25.2 ± 8.8 mg/m2, respectively). All DS-ALL patients have been in complete remission for a median of 10 years 0 month (range: 8 years 10 months-14 years 1 month) as of January 1, 2017. DS-ALL patients may receive the same treatment protocol as that for NDS-ALL patients with adequate care and few modifications, and this strategy may result in the expansion of treatment protocols suitable for DS-ALL patients in the future.http://dx.doi.org/10.1080/2331205X.2017.1304512down syndromeacute lymphocytic leukemiamethotrexate toxicity6-mercaptopurinedose adjustment |
| spellingShingle | Yuki Gemma Fumio Bessho Hiroshi Yoshino Treatment of acute lymphocytic leukemia in Down syndrome Cogent Medicine down syndrome acute lymphocytic leukemia methotrexate toxicity 6-mercaptopurine dose adjustment |
| title | Treatment of acute lymphocytic leukemia in Down syndrome |
| title_full | Treatment of acute lymphocytic leukemia in Down syndrome |
| title_fullStr | Treatment of acute lymphocytic leukemia in Down syndrome |
| title_full_unstemmed | Treatment of acute lymphocytic leukemia in Down syndrome |
| title_short | Treatment of acute lymphocytic leukemia in Down syndrome |
| title_sort | treatment of acute lymphocytic leukemia in down syndrome |
| topic | down syndrome acute lymphocytic leukemia methotrexate toxicity 6-mercaptopurine dose adjustment |
| url | http://dx.doi.org/10.1080/2331205X.2017.1304512 |
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