Korean J Pediatr.  2007 Dec;50(12):1217-1224. 10.3345/kjp.2007.50.12.1217.

The effects of shortened dexamethasone administration on remission rate and potential complications during remission induction treatment for pediatric acute lymphoblastic leukemia

• Lee JW
• Lee KH
• Kwon YJ
• Lee DH
• Chung NG
• Jeong DC
• Cho B
• Kim HK

• KMID: 2279454
• DOI: http://doi.org/10.3345/kjp.2007.50.12.1217

Abstract

PURPOSE: Due to its high potency against leukemic blasts, our institution has opted for the use of dexamethasone during acute lymphoblastic leukemia (ALL) remission induction, but in our most recent treatment protocol, CMCPL-2005, we shortened the length of steroid treatment from 4 to 3 weeks. We compared both the rates of remission induction and significant complications observed during induction with CMCPL-2005, with those noted for our previous protocol, CMCPL-2001.
METHODS
We retrospectively reviewed the records of patients diagnosed with ALL from January, 2001 to December, 2006 at the Department of Pediatrics, St. Mary's Hospital, the Catholic University of Korea. Data concerning age, sex, WBC count at diagnosis, immunophenotype, cytogenetic traits, and risk group were collected for each patient. Results of remission induction treatment were compared between the two patient groups. Infection and other major complications resulting from treatment were investigated according to NCI toxicity criteria.
RESULTS
A total of 141 and 88 patients received remission induction under CMCPL-2001 and CMCPL-2005 respectively. In the CMCPL-2001 group, 136 (96%) achieved complete remission while 82 (93%) achieved CR in the CMCPL-2005 group. Patients in the CMCPL-2005 group were more likely to undergo remission induction without experiencing major complications. However, with regards to steroid related toxicities such as infection, no significant differences were noted.
CONCLUSION
We shortened the length of steroid administration from four to three weeks, yet found the remission induction rate to be comparable to that of our previous regimen. However, rates of steroid related toxicities such as infectious complications remain unchanged despite shortened exposure to dexamethasone.

Keyword

Acute Lymphoblastic Leukemia; Remission induction; Dexamethasone

MeSH Terms

Clinical Protocols
Cytogenetics
Dexamethasone*
Diagnosis
Humans
Korea
Pediatrics
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Remission Induction*
Retrospective Studies
Dexamethasone