Dentofacial development in long-term survivors of acute lymphoblastic leukemia
Article Abstract:
In past years, the prognosis for childhood leukemia was sufficiently poor that improvements in survival were the predominant goal. However, as great strides in treatment have achieved remarkable gains in survival, it is now a concern to provide treatment that not only improves survival, but also spares the child from complications of growth and development, which may result from highly toxic chemotherapeutic drugs and radiation therapy. For this reason, it has become important to characterize the developmental complications that may affect children after treatment for leukemia. Ninety-seven children who had been treated for acute lymphoblastic leukemia at least five years previously were examined for abnormalities of the face and teeth. A total of 94 percent of the children had some sort of abnormal tooth development. These abnormalities included the failure to develop some teeth, small size of some teeth, and abnormalities of the tooth enamel. As might be anticipated, it was found that the observed abnormalities were greatest among the children who were least developed at the time of treatment. Children who had been treated with radiotherapy were more severely affected than those who received chemotherapy alone. Of the 20 children who were treated with radiotherapy prior to the age of five years, 18 had some sort of craniofacial abnormality. Similar abnormalities were not observed among patients who were over the age of five when treated, nor were they observed among children who received radiotherapy doses of less than 2,400 cGy (a Gy, or Gary, is 1 joule of energy absorbed per kilogram of tissue). Unfortunately, the introduction of irradiation of the head is one of the more important advances responsible for improvements in survival from leukemia, and thus it can not be eliminated in favor of other therapies. Nevertheless, the effects of radiation should be considered when therapeutic decisions are made. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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Testicular dysfunction after cyclophosphamide-vincristine-procarbazine-prednisolone chemotherapy for advanced Hodgkin's disease: a long-term follow-up
Article Abstract:
The mustine, vincristine, procarbazine, and prednisolone (MOPP) regimen for Hodgkin's lymphoma has been shown to interfere with the normal function of sperm formation by the testicles. The combination of doxorubicin, bleomycin, and dacarbazine is just as effective and less toxic to the gonads. However, this regimen is considerably more costly, and cannot be widely prescribed in developing countries. To achieve a compromise that might be appropriate for health care needs in India, the COPP protocol, in which cyclophosphamide is substituted for the mustine in MOPP, was evaluated to determine if a reduced rate of infertility might be achieved. Ninety-two patients who had been treated for Hodgkin's disease were evaluated. All had received six to ten cycles of COPP, and all were in remission. None of the patients were found to have sperms, and 89 patients had testicular atrophy. The testosterone levels in these patients were normal. Germinal aplasia was observed in all 19 patients who had a testicular biopsy. It is obvious that patients receiving the COPP regimen are permanently sterilized and that other methods must be considered if men wishing children are to be treated for Hodgkin's disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1990
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Vincristine treatment of acute lymphoblastic leukemia induces transient autonomic cardioneuropathy
Article Abstract:
Many drugs used to manage pediatric leukemia have highly toxic side-effects. In the case of vincristine, neurotoxicity (damage to nerve cells and nerve function) is a potentially serious side effect that may limit the dose of the drug. Symptoms of neurotoxicity are motor dysfunction, muscle weakness, muscle pain, and paresthesia (numbness and tingling). Vincristine treatment for acute lymphoblastic leukemia (characterized by immature while blood cells, lymphocytes and lymphoblasts) may cause neurotoxic side-effects on cardiac function by inducing cardioneuropathy (impairment of the nerves that innervate the heart). Researchers studied the heart rate variability (HRV) of nine children being treated with vincristine for acute lymphoblastic leukemia. Evidence strongly suggests that vincristine severely limited vagal nerve conduction (a nerve involved in contractions of the heart). Researchers advocate close monitoring of the autonomic nervous system among children undergoing therapy with vincristine (the autonomic nervous system effects involuntary body functions, such as heart function). The authors conclude that HRV is a suitable means of monitoring autonomic neurotoxicity.
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1989
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