2001 Volume 15 Issue 1 Pages 32-36
We report our experiences using the ALL-REZ BFM87 for the relapsed childhood lymphocytic malignancy from 1994 to 1998 at Hirosaki University Hospital and affiliated hospitals. Among 19 patients, 12 were induced to their second complete remission (63.2% of remission induction rate), and they were then treated by the consolidation therapy of ALL-REZ BFM87. Two patients relapsed 6 and 10 months after starting chemotherapy. The other 10 received hematopoietic stem cell transplantation (HSCT), and 6 patients relapsed after HSCT. Only 4 patients are still alive in remission. One- and three-year overall survival rates were 63.2% and 31.6%, and one- and three-year disease-free survival rates were 52.6% and 19.7%, respectively. The remission induction rate was relatively good, so ALL-REZ BFM87 would be a useful protocol for the treatment of relapsed childhood lymphocytic malignancy. However, patients with isolated early and very early bone marrow relapse had the least possibility of inducing to the second complete remission. Consequently, more intensive remission induction chemotherapy would be required for these patients with poor prognosis. Furthermore, no patients were cured by the chemotherapy alone, and the three-year-survival rate was disappointing ; thus immediate HSCT could lead to a better outcome for patients with relapse.
