Clinical significance of central nervous system involvement at diagnosis of childhood t-cell acute lymphoblastic leukemia
Background Patients with T‐cell acute lymphoblastic leukemia (T‐ALL) frequently present with unfavorable features at diagnosis. Therefore, they are considered to have a higher risk to relapse. We sought to correlate initial central nervous system (CNS) disease at diagnosis with shortened survival in...
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| Veröffentlicht in: | Pediatric Blood & Cancer 2005-08, Vol.45 (2), p.135-138 |
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| creator | Jaing, Tang-Her Yang, Chao-Ping Hung, Iou-Jih Tsay, Pei-Kwei Tseng, Chen-Kan Chen, Shih-Hsiang |
| description | Background
Patients with T‐cell acute lymphoblastic leukemia (T‐ALL) frequently present with unfavorable features at diagnosis. Therefore, they are considered to have a higher risk to relapse. We sought to correlate initial central nervous system (CNS) disease at diagnosis with shortened survival in childhood T‐ALL.
Procedure
A retrospective analysis of 48 children with T‐ALL was performed. The group consisted of 32 boys and 16 girls whose median age was 8 years. Their CNS status was classified as CNS‐1 (no blast cells in cerebrospinal fluid (CSF); n = 44), CNS‐2 ( |
| doi_str_mv | 10.1002/pbc.20316 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67987994</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>20611976</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4576-529fc081a468a8f1b8bd5afa8af6646a261df18f53a8a067d17e5aca1502597b3</originalsourceid><addsrcrecordid>eNqFkUtP3DAQgC3UCijlwB-ofGklDgE7iR850lV5SKitKqoerYljsy5OvNjJlvz7GnYLJ9STR-NvZjz-EDqi5IQSUp6uWn1SkoryHbRPWc0KRqh48xyTZg-9S-l3RjlhchftUSZIXVK5j-aFd4PT4HFyt4OzORy0wcFibYYx5vxg4jpMCac5jabHblgHvzZ9vsUw4s7B7RCSS08lS-e7ZQgdHgttvMegp9FgP_erZWg9pNFp7M10Z3oH79FbCz6Zw-15gH6ef7lZXBbX3y6uFmfXha6Z4AUrG6uJpFBzCdLSVrYdAwsSLOc1h5LTzlJpWZVThIuOCsNAA2WkZI1oqwP0adN3FcP9ZNKoepceXweDyXspLhopmqb-L1gSTmkjeAaPN6COIaVorFpF10OcFSXqUYjKQtSTkMx-2Dad2t50L-TWQAY-bgFIWYON-f9deuF4IyjjVeZON9wf5838-kT1_fPi3-hiU-GyuIfnCoh3eedKMPXr64ViN4L8OOe1qqq_0l2yjw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>20611976</pqid></control><display><type>article</type><title>Clinical significance of central nervous system involvement at diagnosis of childhood t-cell acute lymphoblastic leukemia</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Jaing, Tang-Her ; Yang, Chao-Ping ; Hung, Iou-Jih ; Tsay, Pei-Kwei ; Tseng, Chen-Kan ; Chen, Shih-Hsiang</creator><creatorcontrib>Jaing, Tang-Her ; Yang, Chao-Ping ; Hung, Iou-Jih ; Tsay, Pei-Kwei ; Tseng, Chen-Kan ; Chen, Shih-Hsiang</creatorcontrib><description>Background
Patients with T‐cell acute lymphoblastic leukemia (T‐ALL) frequently present with unfavorable features at diagnosis. Therefore, they are considered to have a higher risk to relapse. We sought to correlate initial central nervous system (CNS) disease at diagnosis with shortened survival in childhood T‐ALL.
Procedure
A retrospective analysis of 48 children with T‐ALL was performed. The group consisted of 32 boys and 16 girls whose median age was 8 years. Their CNS status was classified as CNS‐1 (no blast cells in cerebrospinal fluid (CSF); n = 44), CNS‐2 (<5 WBC/μl of CSF with blast cells; n = 0), or CNS‐3 (≥5 WBC/μl of CSF with blast cells or signs of CNS involvement; n = 4). For univariate prognostic analyses, we used the log‐rank test to determine the influence of patient characteristics (age, sex, lymphomatous presentations, initial leukocyte count, CNS disease, and newer therapeutic strategies) on each point.
Results
Complete remission was induced in 87.5% of patients. Median survival was 37 months, and 5‐year overall survival and disease‐free survival rates were 49.5% ± 8.1% and 47.1% ± 8.2%, respectively. Patients without initial CNS involvement seemed to have a trend toward longer overall survival (P = 0.036). Disease‐free survival was not influenced by age, leukocyte count, or other factors analyzed.
Conclusions
Patients who present with initial CNS involvement have a prognosis worse than that of patients without CNS disease. The introduction of early and effective CNS‐directed therapy might no longer portend a poor prognosis for CNS leukemia. © 2005 Wiley‐Liss, Inc.</description><identifier>ISSN: 1545-5009</identifier><identifier>EISSN: 1545-5017</identifier><identifier>EISSN: 1096-911X</identifier><identifier>DOI: 10.1002/pbc.20316</identifier><identifier>PMID: 15704218</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Biological and medical sciences ; Central Nervous System Neoplasms - diagnosis ; Central Nervous System Neoplasms - mortality ; Child ; children ; Disease-Free Survival ; Female ; General aspects ; Humans ; Leukemia, T-Cell - diagnosis ; Leukemia, T-Cell - mortality ; Male ; Medical sciences ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality ; Prognosis ; prognostic factor ; Recurrence ; Retrospective Studies ; retrospective study ; Statistics, Nonparametric ; Survival Rate ; T-cell acute lymphoblastic leukemia ; Taiwan - epidemiology ; Tumors</subject><ispartof>Pediatric Blood & Cancer, 2005-08, Vol.45 (2), p.135-138</ispartof><rights>Copyright © 2005 Wiley‐Liss, Inc.</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4576-529fc081a468a8f1b8bd5afa8af6646a261df18f53a8a067d17e5aca1502597b3</citedby><cites>FETCH-LOGICAL-c4576-529fc081a468a8f1b8bd5afa8af6646a261df18f53a8a067d17e5aca1502597b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpbc.20316$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpbc.20316$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16971563$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15704218$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jaing, Tang-Her</creatorcontrib><creatorcontrib>Yang, Chao-Ping</creatorcontrib><creatorcontrib>Hung, Iou-Jih</creatorcontrib><creatorcontrib>Tsay, Pei-Kwei</creatorcontrib><creatorcontrib>Tseng, Chen-Kan</creatorcontrib><creatorcontrib>Chen, Shih-Hsiang</creatorcontrib><title>Clinical significance of central nervous system involvement at diagnosis of childhood t-cell acute lymphoblastic leukemia</title><title>Pediatric Blood & Cancer</title><addtitle>Pediatr. Blood Cancer</addtitle><description>Background
Patients with T‐cell acute lymphoblastic leukemia (T‐ALL) frequently present with unfavorable features at diagnosis. Therefore, they are considered to have a higher risk to relapse. We sought to correlate initial central nervous system (CNS) disease at diagnosis with shortened survival in childhood T‐ALL.
Procedure
A retrospective analysis of 48 children with T‐ALL was performed. The group consisted of 32 boys and 16 girls whose median age was 8 years. Their CNS status was classified as CNS‐1 (no blast cells in cerebrospinal fluid (CSF); n = 44), CNS‐2 (<5 WBC/μl of CSF with blast cells; n = 0), or CNS‐3 (≥5 WBC/μl of CSF with blast cells or signs of CNS involvement; n = 4). For univariate prognostic analyses, we used the log‐rank test to determine the influence of patient characteristics (age, sex, lymphomatous presentations, initial leukocyte count, CNS disease, and newer therapeutic strategies) on each point.
Results
Complete remission was induced in 87.5% of patients. Median survival was 37 months, and 5‐year overall survival and disease‐free survival rates were 49.5% ± 8.1% and 47.1% ± 8.2%, respectively. Patients without initial CNS involvement seemed to have a trend toward longer overall survival (P = 0.036). Disease‐free survival was not influenced by age, leukocyte count, or other factors analyzed.
Conclusions
Patients who present with initial CNS involvement have a prognosis worse than that of patients without CNS disease. The introduction of early and effective CNS‐directed therapy might no longer portend a poor prognosis for CNS leukemia. © 2005 Wiley‐Liss, Inc.</description><subject>Biological and medical sciences</subject><subject>Central Nervous System Neoplasms - diagnosis</subject><subject>Central Nervous System Neoplasms - mortality</subject><subject>Child</subject><subject>children</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Leukemia, T-Cell - diagnosis</subject><subject>Leukemia, T-Cell - mortality</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality</subject><subject>Prognosis</subject><subject>prognostic factor</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>retrospective study</subject><subject>Statistics, Nonparametric</subject><subject>Survival Rate</subject><subject>T-cell acute lymphoblastic leukemia</subject><subject>Taiwan - epidemiology</subject><subject>Tumors</subject><issn>1545-5009</issn><issn>1545-5017</issn><issn>1096-911X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtP3DAQgC3UCijlwB-ofGklDgE7iR850lV5SKitKqoerYljsy5OvNjJlvz7GnYLJ9STR-NvZjz-EDqi5IQSUp6uWn1SkoryHbRPWc0KRqh48xyTZg-9S-l3RjlhchftUSZIXVK5j-aFd4PT4HFyt4OzORy0wcFibYYx5vxg4jpMCac5jabHblgHvzZ9vsUw4s7B7RCSS08lS-e7ZQgdHgttvMegp9FgP_erZWg9pNFp7M10Z3oH79FbCz6Zw-15gH6ef7lZXBbX3y6uFmfXha6Z4AUrG6uJpFBzCdLSVrYdAwsSLOc1h5LTzlJpWZVThIuOCsNAA2WkZI1oqwP0adN3FcP9ZNKoepceXweDyXspLhopmqb-L1gSTmkjeAaPN6COIaVorFpF10OcFSXqUYjKQtSTkMx-2Dad2t50L-TWQAY-bgFIWYON-f9deuF4IyjjVeZON9wf5838-kT1_fPi3-hiU-GyuIfnCoh3eedKMPXr64ViN4L8OOe1qqq_0l2yjw</recordid><startdate>200508</startdate><enddate>200508</enddate><creator>Jaing, Tang-Her</creator><creator>Yang, Chao-Ping</creator><creator>Hung, Iou-Jih</creator><creator>Tsay, Pei-Kwei</creator><creator>Tseng, Chen-Kan</creator><creator>Chen, Shih-Hsiang</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>200508</creationdate><title>Clinical significance of central nervous system involvement at diagnosis of childhood t-cell acute lymphoblastic leukemia</title><author>Jaing, Tang-Her ; Yang, Chao-Ping ; Hung, Iou-Jih ; Tsay, Pei-Kwei ; Tseng, Chen-Kan ; Chen, Shih-Hsiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4576-529fc081a468a8f1b8bd5afa8af6646a261df18f53a8a067d17e5aca1502597b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biological and medical sciences</topic><topic>Central Nervous System Neoplasms - diagnosis</topic><topic>Central Nervous System Neoplasms - mortality</topic><topic>Child</topic><topic>children</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Leukemia, T-Cell - diagnosis</topic><topic>Leukemia, T-Cell - mortality</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality</topic><topic>Prognosis</topic><topic>prognostic factor</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>retrospective study</topic><topic>Statistics, Nonparametric</topic><topic>Survival Rate</topic><topic>T-cell acute lymphoblastic leukemia</topic><topic>Taiwan - epidemiology</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jaing, Tang-Her</creatorcontrib><creatorcontrib>Yang, Chao-Ping</creatorcontrib><creatorcontrib>Hung, Iou-Jih</creatorcontrib><creatorcontrib>Tsay, Pei-Kwei</creatorcontrib><creatorcontrib>Tseng, Chen-Kan</creatorcontrib><creatorcontrib>Chen, Shih-Hsiang</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric Blood & Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jaing, Tang-Her</au><au>Yang, Chao-Ping</au><au>Hung, Iou-Jih</au><au>Tsay, Pei-Kwei</au><au>Tseng, Chen-Kan</au><au>Chen, Shih-Hsiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical significance of central nervous system involvement at diagnosis of childhood t-cell acute lymphoblastic leukemia</atitle><jtitle>Pediatric Blood & Cancer</jtitle><addtitle>Pediatr. Blood Cancer</addtitle><date>2005-08</date><risdate>2005</risdate><volume>45</volume><issue>2</issue><spage>135</spage><epage>138</epage><pages>135-138</pages><issn>1545-5009</issn><eissn>1545-5017</eissn><eissn>1096-911X</eissn><abstract>Background
Patients with T‐cell acute lymphoblastic leukemia (T‐ALL) frequently present with unfavorable features at diagnosis. Therefore, they are considered to have a higher risk to relapse. We sought to correlate initial central nervous system (CNS) disease at diagnosis with shortened survival in childhood T‐ALL.
Procedure
A retrospective analysis of 48 children with T‐ALL was performed. The group consisted of 32 boys and 16 girls whose median age was 8 years. Their CNS status was classified as CNS‐1 (no blast cells in cerebrospinal fluid (CSF); n = 44), CNS‐2 (<5 WBC/μl of CSF with blast cells; n = 0), or CNS‐3 (≥5 WBC/μl of CSF with blast cells or signs of CNS involvement; n = 4). For univariate prognostic analyses, we used the log‐rank test to determine the influence of patient characteristics (age, sex, lymphomatous presentations, initial leukocyte count, CNS disease, and newer therapeutic strategies) on each point.
Results
Complete remission was induced in 87.5% of patients. Median survival was 37 months, and 5‐year overall survival and disease‐free survival rates were 49.5% ± 8.1% and 47.1% ± 8.2%, respectively. Patients without initial CNS involvement seemed to have a trend toward longer overall survival (P = 0.036). Disease‐free survival was not influenced by age, leukocyte count, or other factors analyzed.
Conclusions
Patients who present with initial CNS involvement have a prognosis worse than that of patients without CNS disease. The introduction of early and effective CNS‐directed therapy might no longer portend a poor prognosis for CNS leukemia. © 2005 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>15704218</pmid><doi>10.1002/pbc.20316</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Central Nervous System Neoplasms - diagnosis Central Nervous System Neoplasms - mortality Child children Disease-Free Survival Female General aspects Humans Leukemia, T-Cell - diagnosis Leukemia, T-Cell - mortality Male Medical sciences Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality Prognosis prognostic factor Recurrence Retrospective Studies retrospective study Statistics, Nonparametric Survival Rate T-cell acute lymphoblastic leukemia Taiwan - epidemiology Tumors |
| title | Clinical significance of central nervous system involvement at diagnosis of childhood t-cell acute lymphoblastic leukemia |
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