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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Lower incidence of meningeal leukemia when prednisone is replaced by dexamethasone in the treatment of acute lymphocytic leukemia
Medical and Pediatric Oncology, Volume 19, No. 4, Year 1991
Notification
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Description
In 1971, Cancer and Leukemia Group B (CALGB) mounted a study of acute lymphocytic leukemia (ALL) that compared the effects of the two steroid hormones dexa‐methasome and prednisone. Six‐hundred‐forty‐six children and adolescents with ALL were randomized to receive either prednisone or dexamethasone as part of their remission induction therapy. The 493 evaluable patients who achieved complete remission received the same steroid as pulses throughout remission. Specific central nervous system (CNS) therapy was randomized to either six injections of intrathecal methotrexate (IT MTX) alone or to six injections of IT MTX with cranial radiation (2,400 cGy). Both cranial radiation and dexamethasone offered increased protection against CNS relapse as the first site of failure over IT MTX alone. There were 30 CNS relapses among 238 patients (12.6%) receiving cranial radiation plus IT MTX, whereas there were 70 CNS relapses among 225 (P < 0.001) (22.5%) in those who received IT MTX alone. Similarly, there were 33 CNS relapses among 231 (14.3%) children treated with dexamethasone, whereas there were 67 CNS relapses among 262 (25.6%) treated with prednisone (P = 0.017). Both steroids appeared equal in protecting the bone marrow. Recent national studies have shown significant improvements in preventing CNS relapse over the results in the present report. However, this finding warrants further investigation and, with further documentation, could lead to the substitution of prednisone by dexamethasone to aid further in preventing CNS relapse. This may be particularly important in patients at higher risk for CNS relapse. Copyright © 1991 Wiley‐Liss, Inc., A Wiley Company
Authors & Co-Authors
Jones, Barbara T.
Unknown Affiliation
Freeman, A.
United States, Buffalo
Roswell Park Cancer Institute
Shuster, Jonathan J.
United States, Gainesville
University of Florida
Jacquillat, Claude I.
France, Paris
Hôpital Saint-louis
Weil, Marise
France, Paris
Hôpital Saint-louis
Pochedly, Carl E.
United States, New York
The Mount Sinai Hospital
Sinks, Lucius F.
United States, Buffalo
Roswell Park Cancer Institute
Chevalier, Louise M.
Canada, Montreal
Centre Universitaire de Santé Mcgill, Hôpital de Montreal Pour Enfants
Maurer, Harold M.
United States, Richmond
Medical College of Virginia
Koch, Kjell
United States, Coral Gables
University of Miami
Falkson, Geoffrey G.
South Africa, Pretoria
University of Pretoria
Patterson, Richard B.
United States, Winston Salem
Wake Forest University School of Medicine
Seligman, Barbara R.
United States, Albany
State University of new York System
Sartorius, Jurg A.
Switzerland, Basel
Universitäts-kinderspital Beider Basel
Kung, Faith H.
United States, La Jolla
University of California, San Diego
Haurani, Farid I.
United States, Philadelphia
Jefferson Medical College
Stuart, Marie J.
United States, Syracuse
Suny Upstate Medical University
Burgert, E. Omer
United States, Rochester
Mayo Clinic
Ruymann, Frederick B.
United States, Bethesda
Walter Reed National Military Medical Center
Sawitsky, Authrur
United States, New Hyde Park
Long Island Jewish Medical Center
Forman, Edwin N.
United States, Providence
Brown University
Pluess, Hansjuerg J.
Unknown Affiliation
Truman, John T.
United States, Boston
Massachusetts General Hospital
Hakami, Nasrollah
United States, Columbia
University of Missouri
Glidewell, Oliver J.
Unknown Affiliation
Glicksman, Arvin S.
United States, Providence
Brown University
Holland, James F.W.
United States, New York
Usmount Sinai Medical School
Statistics
Citations: 148
Authors: 27
Affiliations: 21
Identifiers
Doi:
10.1002/mpo.2950190411
ISSN:
00981532
e-ISSN:
1096911X
Research Areas
Cancer
Maternal And Child Health
Study Design
Cohort Study