Remission death in acute lymphoblastic leukaemia: a changing pattern.

The pattern of remission deaths was examined in 842 children with acute lymphoblastic leukaemia (ALL) treated at a single centre over 18 years. The mortality rate from leukaemia fell significantly during three consecutive time periods during which treatment became progressively more intensive and th...

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Váldodahkkit: Atra, A, Richards, S, Chessells, J
Materiálatiipa: Journal article
Giella:English
Almmustuhtton: 1993
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author Atra, A
Richards, S
Chessells, J
author_facet Atra, A
Richards, S
Chessells, J
author_sort Atra, A
collection OXFORD
description The pattern of remission deaths was examined in 842 children with acute lymphoblastic leukaemia (ALL) treated at a single centre over 18 years. The mortality rate from leukaemia fell significantly during three consecutive time periods during which treatment became progressively more intensive and that during remission induction fell from 3.5% to under 1%, but the rate of death in remission stayed constant at 5-6%. The factors associated with an increased risk of remission death were: young age, a higher leucocyte count, bone marrow transplantation, and Down's syndrome. The pattern of remission deaths changed over the years; measles and herpes viruses decreased while deaths associated with periods of intensification and gut toxicity increased. Four children developed second neoplasms. Treatment of ALL is still associated with a significant risk of death in remission but the pattern of infective deaths has changed. Many should be avoidable by provision of adequate supportive care, close supervision after periods of intensive treatment, and appropriate antibiotic, antifungal, and cytokine therapy.
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spelling oxford-uuid:bc3adf10-1b5e-495f-a06b-2c1763b3c4a12022-03-27T05:22:51ZRemission death in acute lymphoblastic leukaemia: a changing pattern.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bc3adf10-1b5e-495f-a06b-2c1763b3c4a1EnglishSymplectic Elements at Oxford1993Atra, ARichards, SChessells, JThe pattern of remission deaths was examined in 842 children with acute lymphoblastic leukaemia (ALL) treated at a single centre over 18 years. The mortality rate from leukaemia fell significantly during three consecutive time periods during which treatment became progressively more intensive and that during remission induction fell from 3.5% to under 1%, but the rate of death in remission stayed constant at 5-6%. The factors associated with an increased risk of remission death were: young age, a higher leucocyte count, bone marrow transplantation, and Down's syndrome. The pattern of remission deaths changed over the years; measles and herpes viruses decreased while deaths associated with periods of intensification and gut toxicity increased. Four children developed second neoplasms. Treatment of ALL is still associated with a significant risk of death in remission but the pattern of infective deaths has changed. Many should be avoidable by provision of adequate supportive care, close supervision after periods of intensive treatment, and appropriate antibiotic, antifungal, and cytokine therapy.
spellingShingle Atra, A
Richards, S
Chessells, J
Remission death in acute lymphoblastic leukaemia: a changing pattern.
title Remission death in acute lymphoblastic leukaemia: a changing pattern.
title_full Remission death in acute lymphoblastic leukaemia: a changing pattern.
title_fullStr Remission death in acute lymphoblastic leukaemia: a changing pattern.
title_full_unstemmed Remission death in acute lymphoblastic leukaemia: a changing pattern.
title_short Remission death in acute lymphoblastic leukaemia: a changing pattern.
title_sort remission death in acute lymphoblastic leukaemia a changing pattern
work_keys_str_mv AT atraa remissiondeathinacutelymphoblasticleukaemiaachangingpattern
AT richardss remissiondeathinacutelymphoblasticleukaemiaachangingpattern
AT chessellsj remissiondeathinacutelymphoblasticleukaemiaachangingpattern