화학요법 종료 후 재발(Late Relapse)된 소아 급성 림프구성 백혈병 환자에서 복합화학요법(R-11)에 따른 치료결과

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.