Document Detail

Moyamoya syndrome following childhood acute lymphoblastic leukemia.
MedLine Citation:
PMID:  16615044     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Long-term survivors of childhood acute lymphoblastic leukemia (ALL) sometimes suffer from adverse long-term sequelae. We analyzed the incidence, clinical course and prognosis of moyamoya syndrome (MoS) following childhood ALL. PROCEDURE: A total of 1,846 ALL patients were treated with four consecutive TCCSG ALL protocols (L84-11, L89-12, L92-13, and L95-14) between 1984 and 1999. We surveyed the MoS cases among these patients in the follow-up studies. RESULTS: Six patients with MoS were identified: four boys and two girls whose ages ranged from 2 years and 1 month (abbreviated as "2y1m") to 14y 1 m at diagnosis of ALL. None of the patients had central nervous system (CNS) leukemia. All six patients received prophylactic cranial irradiation with a dosage of 18 or 24 Gy. Although one patient died of brain infarction due to MoS, no leukemic relapse was observed in the group. The cumulative incidence of MoS in our series was 0.46 +/- 0.02% at 8 years. Among several clinical characteristics, use of cranial irradiation was the only factor that appeared to be significantly related to the development of MoS. CONCLUSIONS: MoS occurs with increased frequency in children treated for ALL, and might be associated with cranial irradiation. Prophylactic cranial irradiation should be used cautiously in ALL patients who can be cured by other CNS-directed therapies.
Akira Kikuchi; Miho Maeda; Ryoji Hanada; Yuri Okimoto; Koichi Ishimoto; Takashi Kaneko; Koichiro Ikuta; Masahiro Tsuchida;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  48     ISSN:  1545-5009     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-01-10     Completed Date:  2007-04-03     Revised Date:  2009-01-12    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  268-72     Citation Subset:  IM    
Copyright Information:
(c) 2006 Wiley-Liss, Inc.
Division of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan.
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MeSH Terms
Anthracyclines / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Asparaginase / administration & dosage
Cerebral Infarction / etiology
Child, Preschool
Combined Modality Therapy
Cranial Irradiation / adverse effects*
Cyclophosphamide / administration & dosage
Dexamethasone / administration & dosage
Disease Susceptibility
Follow-Up Studies
Japan / epidemiology
Moyamoya Disease / diagnosis,  epidemiology,  etiology*,  genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*,  drug therapy,  radiotherapy
Prednisolone / administration & dosage
Quality of Life
Remission Induction
Vincristine / administration & dosage
Reg. No./Substance:
0/Anthracyclines; 50-02-2/Dexamethasone; 50-18-0/Cyclophosphamide; 50-24-8/Prednisolone; 57-22-7/Vincristine; EC

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