Post-Remission Treatment
Overview If a complete remission is achieved following remission-induction therapy and no further treatment given, over 90% of patients will have a recurrence of leukemia in weeks to months. However, treatment of standard-risk children with ALL with intensive post-remission therapy can cure 70-80%. It is important to understand what determines the success or failure of…
Refractory ALL
Overview Children with progressive or relapsed ALL remain curable despite failing initial treatment. Patients failing treatment can be divided into two broad categories. Patients who fail to achieve an initial complete disappearance or remission of their cancer following a complete course of remission-induction chemotherapy treatment are referred to as “induction failures”. Patients who achieve a…
Chronic Lymphocytic Leukemia
Overview Chronic lymphocytic leukemia (CLL) is a disease characterized by high numbers of circulating abnormal lymphocytes (B-Cells) in the peripheral blood. The disease often involves enlargement of lymph nodes in various parts of the body as well as enlargement of the spleen. In CLL the marked elevation of lymphocytes in the blood is partially due…
Early-stage Asymptomatic CLL
Overview Patients with early-stage CLL have Binet Stage A or RAI Stage 0-II disease and no symptoms. In general, patients with asymptomatic early-stage CLL should not be treated unless they are participating in a clinical trial evaluating the effects of therapy on patients with adverse prognostic features. A variety of factors ultimately influence a patient’s…
Symptomatic Advanced CLL
Overview Chronic lymphocytic leukemia (CLL) is a heterogenous disease with some patients progressing rapidly and others living for years without treatment. Nevertheless, most patients with symptomatic advanced CLL receive treatment. Accepted indications for the initiation of treatment of CLL include the following: Anemia (hemoglobin level less than 11.0 g/dL) Thrombocytopenia (platelet count less than 100,000/mm3)…