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The Effect of Intermittent Craniospinal Irradiation and Intrathecal Chemotherapy for Overt Meningeal Leukemia
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Á¤¼ö¹Ì(Chung Su-Mi) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú
½Å°æ¼·(Shinn Kyung-Sub) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú
Abstract
°¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú¿¡¼ 1988³âºÎÅÍ 1992³âµµ±îÁö ÀûÀýÇÑ ÁßÃ߽Űæ°è ¿¹¹æ¿ä¹ýÈÄ ³úô¼ö¾×³» Àç¹ßÀ» °æÇèÇÑ ±Þ¼º ÀÓÆı¸¼º ¹éöº´ ȯÀÚ 7¸íÀ» ´ë»óÀ¸·Î °£ÇæÀûÀÎ ÀüÁßÃ߽Űæ°è ¹æ»ç¼±Á¶»ç ¹× ô¼ö°³» ÈÇпä¹ý(¥²C)À» ½Ç½ÃÇÏ¿´´Ù. ÃßÀû°üÂû±â°£Àº 8°³¿ù¿¡¼ 41°³¿ùÀ̾ú°í ±× Áß¾Ó°ªÀº 20°³¿ùÀ̾ú´Ù. 7¸íÀÇ ´ë»óȯÀÚ Áß 3¸íÀÌ ´Ù½Ã ³úô¼ö¾×³» Àç¹ßÀ» °æÇèÇÏ¿´°í, ÁßÃ߽Űæ°è °üÇØ À¯Áö±â°£Àº °¢°¢ 8, 9, 13, 20, 34, 36°³¿ùÀ̾ú´Ù. ¹«º´»ýÁ¸±â°£Àº 2°³¿ù¿¡¼ 36°³¿ù·Î ±× Áß¾Ó°ªÀº 11°³¿ùÀ̾ú´Ù. »ýÁ¸À²Àº 8°³¿ù¿¡¼ 41°³¿ù·Î ±× Áß¾Ó°ªÀº 28°³¿ùÀ̾ú´Ù. 5¸íÀÌ Ä¡·á±â°£ Áß °ñ¼öÀç¹ß¿¡ µû¸¥ ÆÐÇ÷Áõ ¹× ÃâÇ÷·Î »ç¸ÁÇÏ¿´°í, 2¸íÀÇ »ýÁ¸ÀÚ´Â Ä¡·áÁ¾·á 17°³¿ù ¹× 11°³¿ù° ´Ù½Ã ³úô¼ö¾×³» Àç¹ßÀ» °æÇèÇÏ¿´´Ù. Ä¡·á°á°ú¸¦ Çâ»ó½ÃÅ°±â À§Çؼ´Â Ä¡·á Áß È޽ıⰣÀ» ´ÜÃà½ÃÅ°°í, Ä¡·á ÈÄ¿¡µµ ÀÏÁ¤±â°£µ¿¾È ô¼ö°³» À¯ÁöÈÇпä¹ýÀ» ¿¬ÀåÇÏ¿© ½Ç½ÃÇÏ´Â µî Ä¡·á°èȹÀÇ º¯ÇüÀÌ ÇÊ¿äÇÒ °ÍÀ¸·Î »ç·áµÇ¾ú´Ù.
Between 1988 and 1992, seven patients with overt meningeal leukemia who had received adequate central nervous system (CNS) prophylaxis were treated with intermittent craniospinal irradiation and intrathecal methotrexate(¥²C). Follow-up time ranged from 8 months to 41 months with median of 20 months. Three of 7 patients developed subsequent CNS relapse. CNS remission durations were 8, 9, 13, 20, 28, 34, 36 months from diagnosis of CNS leukemia for which ¥²C was given. Disease free survival after CNS relapse ranged from 2 to 36 months with median of 11 months. Overall survival after CNS relapse ranged from 8 to 41 months with median of 28 months. Five patients died of sepsis and bleeding secondary to bone marrow relapse. Two patients are alive at present. But they developed recurrent CNS disease 10 to 11 months after completion of ¥²C. To improve the outcome, modification of ¥²C by reduction of rest period and prolonged administration of intrathecal chemotherapy after completion of ¥²C are required.
Å°¿öµå
Acute lymphocytic leukemia, Meningeal relapse, Intermittent craniospinal irradiation
KMID :
0362919930110020403
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À¯È¿¼º°á°ú(Recomendation)
Disease free survival after CNS relapse ranged from 2 to 36 months with median of 11 months. Overall survival after CNS relapse ranged from 8 to 41 months with median of 28 months.