복수 재발한 급성림프구성 백혈병 1예에서중추신경계 질환 치료 방법 (Comparison of Central Nervous System Therapy in a Leukemic Child who had Multiple Meningeal Relapses; A Case Report)

서지정보

· 발행기관 : 고신대학교(의대) 고신대학교 의과대학 학술지
· 수록지 정보 : 고신대학교 의과대학 학술지 / 18권 / 1호 / 1 ~ 5페이지
· 저자명 : 지종현, 홍유라, 박성인, 박재선

초록

Methotrexate (MTX) is one of the most widely used drugs for the treatment of childhood acute lymphoblastic leukemia (ALL) and is commonly given in high doses. Systemic chemotherapy, triple intrathecal (TIT) treatment and craniospinal radiation was given to a child with meningeal involvement at presentation. But meningeal leukemia was recurred 3 months later, which was remissioned secondly by TIT chemotherapy. One year later from first diagnosis, second meningeal relapse was presented with immature cell count of 12/mm3 in CSF and a large intracerebral mass on brain CT. A high-dose methotrexate (HDMTX) had been challenged in dose of 2.8-5.0 g/m2 with TIT chemotherapy. In HDMTX schedule, leucovorin (LCV) was administered orally (12 times, 15 mg/m2 every 6 hours), 24 hours later from the start. Intracerebral mass disappeared two weeks later (with 2 weekly administration of HDMTX) and the third remission was lasted for 80 months. Third isolated meningeal relapse, which occurred on July 28, 2000, remissioned again with HDMTX plus TIT chemotherapy, but he died of fungal sepsis and interstitial pneumonia. Although the patient died of treatment related disease, systemic intravenous HDMTX and TIT therapy appears to provide another option in the treatment of relapsed meningeal leukemia after craniospinal irradiation.

영어초록

Methotrexate (MTX) is one of the most widely used drugs for the treatment of childhood acute lymphoblastic leukemia (ALL) and is commonly given in high doses. Systemic chemotherapy, triple intrathecal (TIT) treatment and craniospinal radiation was given to a child with meningeal involvement at presentation. But meningeal leukemia was recurred 3 months later, which was remissioned secondly by TIT chemotherapy. One year later from first diagnosis, second meningeal relapse was presented with immature cell count of 12/mm3 in CSF and a large intracerebral mass on brain CT. A high-dose methotrexate (HDMTX) had been challenged in dose of 2.8-5.0 g/m2 with TIT chemotherapy. In HDMTX schedule, leucovorin (LCV) was administered orally (12 times, 15 mg/m2 every 6 hours), 24 hours later from the start. Intracerebral mass disappeared two weeks later (with 2 weekly administration of HDMTX) and the third remission was lasted for 80 months. Third isolated meningeal relapse, which occurred on July 28, 2000, remissioned again with HDMTX plus TIT chemotherapy, but he died of fungal sepsis and interstitial pneumonia. Although the patient died of treatment related disease, systemic intravenous HDMTX and TIT therapy appears to provide another option in the treatment of relapsed meningeal leukemia after craniospinal irradiation.

참고자료

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