Korean J Pediatr Hematol Oncol.  2001 Oct;8(2):197-205.

The Clinical Outcome of Protocol R-11 Chemotherapy in Patients with Late Relapse of Childhood Acute Lymphoblastic Leukemia

• Kim BN
• Lee KJ
• Lyu CJ
• Yang CH
• Kim KY
• Kim HM

Abstract

PURPOSE: This study is to see chemotherapeutic results followed by Rotational Combination Chemotherapy (R-11 protocol) treatment for the patients with late relapse of childhood ALL six months after the completion of chemotherapy.
METHODS
The subjects of study were the 13 children who had been diagnosed as ALL at the Severance Hospital and the Wonju Christian Hospital and completed the chemotherapy. They, however, diagnosed a late relapse of ALL between December, 1996 and December, 2001. After that, they were given an chemotherapy with R-11 protocol.
RESULTS
The average age of the 13 patients was 11.8 ( 2.8) years old at relapse. They showed the complete remission (8 patients, 61%), partial remission (4, 31%), and induction failure (1, 8%). The total remission ratio was 92%. Four year Event Free Survival (EFS) after the second remission was 61.5%. They also showed acute toxicity during remission induction with severe than grade III according to the WHO criteria. The leukopenia and thrombocytopenia (hematologic toxicity) were seen at 11 cases (84%) and 9 cases (69%) respectively, and hepatotoxicity (non-hematologic toxicity) was shown at 6 cases (46%). There are also chronic toxicity, one case developed leukomalacia, and 6 cases did various symptoms of infections.
CONCLUSION
There is no optimal chemotherapeutic protocol for late relapse of childhood ALL, and the treatment with R-11 protocol is worth a trial.

Keyword

Acute lymphoblastic leukemia; Late relapse; Rotational combination chemotherapy

MeSH Terms

Child
Disease-Free Survival
Drug Therapy*
Drug Therapy, Combination
Gangwon-do
Humans
Leukopenia
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Recurrence*
Remission Induction
Thrombocytopenia