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題名 | Treatment of Testicular Relapse in Childhood Acute Lymphoblastic Leukemia=孩童期急性淋巴性白血病睪丸復發之治療 |
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作者 | 黃兆聖; 梁德城; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 33:6 民81.11-12 |
頁次 | 頁401-407 |
分類號 | 417.5515 |
關鍵詞 | 白血病; 治療; 孩童; 急性; 淋巴性; 睪丸; |
語文 | 英文(English) |
中文摘要 | 在本報告中,共有6位急性淋巴性白血病合併睪丸復發的病童接受治療,其中有二位是化學治療完成後1年及4年復發,二位在接受治療中復發,另二位因過早自行停藥而發生睪丸復發。有二位只是睪丸復發,其他4例則合併骨髓或中樞神經系復發。其拯救治療包括:兩邊睪丸的放射線治療24 Gy,再加上TCL 821或TCL 842對付高危險群急性淋巴性血病之療法,予系統性再引導化學治療後,繼之以維持治療;中樞神經系預防包括髓鞘內化學治療,或加以腦部放射線治療18 Gy。全部治療期兩年。治療後,有一病人仍發生骨髓及中樞神經系復發,於是予以更強的治療。另一例在睪丸復發的治療中過早自行停藥,發生中樞神經系復發,然後再接受治療。一例在診斷時即有中樞神經系侵犯,七個月後有睪丸和中樞神經系復發,再過三個月死亡。剩餘5例仍持續緩解中,達26到95個月,中位數爲54個月。 |
英文摘要 | The experience of rescue therapy for 6 patients of childhood acute lymphoblastic leukemia (ALL) with testicular relapse is reported. In two patients, testicular relapse occurred 1 and 4 years off therapy, respectively. Two patients had testicular relapse on therapy. The remaining 2 patients had testicular relapse after premature discontinuation of therapy by the parents. Isolated testicular relapse was found in 2 patients. The rest of the testicular relapses were concurrent with either bone marrow (BM) or central nervous system (CNS) relapses. The rescue therapy included bilateral testicular irradiation 24 Gy, and systemic reinduction chemotherapy, followed by maintenance therapy as that of TCL 821 or TCL 842 protocol for high risk patients of ALL. CNS prophylaxis, which included intrathecal medication and/or cranial irradiation 18 Gy (if not given before), was also given. After testicular relapse, one had subsequent BM and CNS relapses and received more aggressive chemotherapy. Another one had subsequent CNS relapse 4 months after another premature withdrawal of treatment. One patient, who presented with CNS leukemia at diagnosis, had concurrent testicular and CNS relapses and died of CNS leukemia 3 moths later. The remaining 5 patients remained in continuous complete remission for 26 to 95 months with a median duration of 54 months. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。