Korean Journal of Pediatrics 2007;50(12):1217-1224.
Published online December 15, 2007.
The effects of shortened dexamethasone administration on remission rate and potential complications during remission induction treatment for pediatric acute lymphoblastic leukemia
Jae Wook Lee1, Kwang Hee Lee1, Young Joo Kwon1, Dae Hyoung Lee2, Nak Gyun Chung1, Dae Chul Jeong1, Bin Cho1, Hack Ki Kim1
1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
2Department of Pediatrics, College of Medicine, Hallym University, Seoul, korea
급성림프구성백혈병 환아의 관해유도 치료 중 덱사메타손투여기간의 단축이 관해유도율 및 합병증 발생에 미치는 영향
이재욱1, 이광희1, 권영주1, 이대형2, 정낙균1, 정대철1, 조빈1, 김학기1
1가톨릭대학교 의과대학 소아과학교실
2한림대학교 의과대학 소아과학교실
Correspondence: 
Young Joo Kwon, Email: dine0110@catholic.ac.kr
Abstract
Purpose
: Due to its high potency against leukemic blasts, our institution has opted for the use of dexamethasone during acute lymphoblastic leukemia (ALL) remission induction, but in our most recent treatment protocol, CMCPL-2005, we shortened the length of steroid treatment from 4 to 3 weeks. We compared both the rates of remission induction and significant complications observed during induction with CMCPL-2005, with those noted for our previous protocol, CMCPL-2001.
Methods
: We retrospectively reviewed the records of patients diagnosed with ALL from January, 2001 to December, 2006 at the Department of Pediatrics, St. Mary's Hospital, the Catholic University of Korea. Data concerning age, sex, WBC count at diagnosis, immunophenotype, cytogenetic traits, and risk group were collected for each patient. Results of remission induction treatment were compared between the two patient groups. Infection and other major complications resulting from treatment were investigated according to NCI toxicity criteria.
Results
: A total of 141 and 88 patients received remission induction under CMCPL-2001 and CMCPL- 2005 respectively. In the CMCPL-2001 group, 136 (96%) achieved complete remission while 82 (93%) achieved CR in the CMCPL-2005 group. Patients in the CMCPL-2005 group were more likely to undergo remission induction without experiencing major complications. However, with regards to steroid related toxicities such as infection, no significant differences were noted.
Conclusion
: We shortened the length of steroid administration from four to three weeks, yet found the remission induction rate to be comparable to that of our previous regimen. However, rates of steroid related toxicities such as infectious complications remain unchanged despite shortened exposure to dexamethasone.
Key Words: Acute Lymphoblastic Leukemia, Remission induction, Dexamethasone


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