Treatment of childhood acute lymphoblastic leukemia after the first relapse: curative strategies.

摘要: BACKGROUND AND OBJECTIVE: The aim of this study was a retrospective analysis the presenting features extramedullary plasmacytoma, its response to therapy and clinical course. DESIGN METHODS: Forty-six cases diagnosed between August 1970 June 1993 were carefully reviewed. follow-up continued until 1998 median observation time 118 months. RESULTS: disease most frequently localized in upper airways (37/46; 80%), with mass limited single site all but seven patients whom two contiguous sites involved. Other localizations lymph nodes, thyroid, skin, stomach, brain. symptoms related presentation, appearance diagnosis 7.5 age at 55 years (range 16-80), 14 (30%) being under 50 old. disorder approximately twice as common males females. Ten (21%) had monoclonal component. therapeutic strategy varied, although frequent form treatment local radiotherapy. Thirty-nine (85%) achieved complete remission (CR), five (11%) partial (PR) (4%) did not respond (NR). Local recurrence (LR) or other (ROS) occurred 7.5% 10%, respectively. Seven (15%) developed multiple myeloma (MM), characterized by osteolysis almost soft tissue involvement some them. 15 year survival rate 78%. INTERPRETATION CONCLUSIONS: This review relatively large series confirms favorable prognosis EMP when treated locally irradiation and/or surgery.