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2011, Number 2

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Rev Hematol Mex 2011; 12 (2)

Efficacy of triple intrathecal therapy in patients with acute lymphoblastic leukemia

Ramos-Peñafiel CO, Castellanos-Sinco H, Adolfo Martínez-Tovar, Efreen Montaño-Figueroa, Carlos Martínez-Murillo, Irma Olarte-Carrillo, Juan Collazo-Jaloma, Etta Rozen-Fuller

Language: Spanish
References: 35
Page: 57-61
PDF size: 74.67 Kb.


ABSTRACT

The acute lymphoid leukemia is a malignant neoplasm originating from immature T or B lymphoid cells. The clinical spectrum is variable involving various cytogenetic and molecular alterations. The treatment is divided into various stages: induction, consolidation and maintenance; among these is the central nervous system prophylaxis, without this the possibility of relapse is about 50%. Various strategies have been made as a prophylaxis, the main are skull radiotherapy and intrathecal chemotherapy. With these, infiltration rate has been reduced by 5%. Recently, several protocols have displaced intrathecal chemotherapy to cranial radiotherapy due to side effects. In the Hospital General de México since 2007 radiation therapy was replaced for an intensive protocol based on triple drug intrathecal chemotherapy (methotrexate, cytarabine, steroids). This study analyzed 153 patients under the institutional protocol HGMLAL07/09, the central nervous system infiltration was recorded only in a 2% of cases. The incidence of relapse was 2% in a 34 months follow –up period. In conclusion the triple drug prophylaxis is an effective therapy for the prevention of central nervous system relapse in patients with acute lymphoid leukemia.


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