Delayed central nervous system (CNS) radiation in childhood CNS acute lymphoblastic leukemia

Article Abstract:

Childhood acute lymphoblastic leukemia is a type of blood cancer that is characterized by the unrestrained growth of lymphoblasts, a cell that gives rise to a lymphocyte (a type of white blood cell). Preventive treatment with anticancer agents can reduce the incidence of central nervous system relapse, or the recurrence of cancer in the brain and spinal cord. Five to 10 percent of children do not receive preventive treatment and develop central nervous system relapse. In July 1985, a study was started to examine the effectiveness of administering chemotherapy before radiation treatment in 10 leukemic patients with central nervous system relapse. One patient did not respond to pretreatment with anticancer drugs before radiation therapy and died within two months after the start of treatment. Nine patients completed radiation therapy to the central nervous system. Five of these patients did not require further therapy and have been in remission for 38 months. Two other patient have almost completed treatment, and are free of disease at 22 and 24 months. The recurrence of cancer in the testes occurred in two patients at 14 and 29 months. These findings show that pretreatment for central nervous system relapse with anticancer agents delays the need for radiation treatment without affecting the development or duration of remission. The delay permitted the use of several anticancer agents to prevent the recurrence of cancer systemically. It also helped to distinguish patients who would suffer an early systemic relapse from those who would achieve complete remission. Pretreatment with anticancer agents may reduce the need for additional chemotherapy after radiation treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Antineoplastic agents

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Skeletal muscle wasting and protein-energy malnutrition in children with newly diagnosed acute leukemia

Article Abstract:

Skeletal muscle serves as the largest store of protein in the body and provides a source of protein during conditions of stress and injury. When energy and protein requirements are increased and nutrient protein intake is decreased, the breakdown of muscle exceeds the normal protein turnover or production rate. Skeletal muscle wasting or breakdown occurs in many disease processes; the protein mass in the liver is maintained. The extent of muscle wasting was evaluated in 14 children with acute leukemia, a blood cancer, during a 24-week period of aggressive chemotherapy. Muscle changes were assessed by measuring the thickness of the femoral quadriceps or thigh muscle. The levels of the blood protein albumin were measured to determine the changes in muscle protein. Muscle wasting was most evident at four to six weeks after disease onset. Results confirmed that the muscle index, a measure of skeletal muscle mass, decreased by an average of 27 percent. Because fat tissue simultaneously increased, body weight and limb circumference did not decrease. In these children, the recovery of muscle mass occurred within six months. The findings demonstrate that measurements of body weight and limb circumference do not reflect the depletion of nutritional protein and muscle wasting in children with acute leukemia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Physiological aspects, Muscles, Protein metabolism

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