Open-wedge testicular biopsy in childhood acute lymphoblastic leukemia after two years of maintenance therapy

Diagnostic accuracy and influence on outcome - A report from Children's Cancer Study Group

J. Nachman, N. F. Palmer, H. N. Sather, W. A. Bleyer, Peter Felix Coccia, J. N. Lukens, S. E. Siegel, G. D. Hammond

Research output: Contribution to journalArticle

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Abstract

Bilateral testicular biopsies were performed on 708 males with acute lymphoblastic leukemia completing 24 to 30 months of maintenance chemotherapy in continuous remission. The 73 patients (10.3%) with occult testicular leukemia (TL) had a significantly increased risk of subsequent relapse (P = .0001) and death (P < .0001) when compared with patients with negative biopsies. Protocol-specified therapy for occult TL included reinduction therapy with concurrent bilateral testicular radiation, and 2 years of maintenance therapy. Four-year event-free survival for patients with negative biopsies was 78.2% ± 4% versus 65% ± 14% for patients with occult TL who received protocol-specified therapy (P = .05). This study suggests that (1) occult TL occurs in 10% of males completing 2 years of maintenance therapy; (2) occult TL significantly increases risk for subsequent relapse and death; (3) treatment results for occult TL and isolated overt off therapy TL (no previous biopsy) are similar; and (4) given current therapy, documentation of occult TL after 2 years of therapy does not improve disease-free survival.

Original languageEnglish (US)
Pages (from-to)1051-1055
Number of pages5
JournalBlood
Volume75
Issue number5
StatePublished - Jan 1 1990

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Biopsy
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia
Neoplasms
Chemotherapy
Therapeutics
Disease-Free Survival
Radiation
Maintenance Chemotherapy
Recurrence
Documentation

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Open-wedge testicular biopsy in childhood acute lymphoblastic leukemia after two years of maintenance therapy : Diagnostic accuracy and influence on outcome - A report from Children's Cancer Study Group. / Nachman, J.; Palmer, N. F.; Sather, H. N.; Bleyer, W. A.; Coccia, Peter Felix; Lukens, J. N.; Siegel, S. E.; Hammond, G. D.

In: Blood, Vol. 75, No. 5, 01.01.1990, p. 1051-1055.

Research output: Contribution to journalArticle

Nachman, J, Palmer, NF, Sather, HN, Bleyer, WA, Coccia, PF, Lukens, JN, Siegel, SE & Hammond, GD 1990, 'Open-wedge testicular biopsy in childhood acute lymphoblastic leukemia after two years of maintenance therapy: Diagnostic accuracy and influence on outcome - A report from Children's Cancer Study Group', Blood, vol. 75, no. 5, pp. 1051-1055.
Nachman, J. ; Palmer, N. F. ; Sather, H. N. ; Bleyer, W. A. ; Coccia, Peter Felix ; Lukens, J. N. ; Siegel, S. E. ; Hammond, G. D. / Open-wedge testicular biopsy in childhood acute lymphoblastic leukemia after two years of maintenance therapy : Diagnostic accuracy and influence on outcome - A report from Children's Cancer Study Group. In: Blood. 1990 ; Vol. 75, No. 5. pp. 1051-1055.
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abstract = "Bilateral testicular biopsies were performed on 708 males with acute lymphoblastic leukemia completing 24 to 30 months of maintenance chemotherapy in continuous remission. The 73 patients (10.3{\%}) with occult testicular leukemia (TL) had a significantly increased risk of subsequent relapse (P = .0001) and death (P < .0001) when compared with patients with negative biopsies. Protocol-specified therapy for occult TL included reinduction therapy with concurrent bilateral testicular radiation, and 2 years of maintenance therapy. Four-year event-free survival for patients with negative biopsies was 78.2{\%} ± 4{\%} versus 65{\%} ± 14{\%} for patients with occult TL who received protocol-specified therapy (P = .05). This study suggests that (1) occult TL occurs in 10{\%} of males completing 2 years of maintenance therapy; (2) occult TL significantly increases risk for subsequent relapse and death; (3) treatment results for occult TL and isolated overt off therapy TL (no previous biopsy) are similar; and (4) given current therapy, documentation of occult TL after 2 years of therapy does not improve disease-free survival.",
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N2 - Bilateral testicular biopsies were performed on 708 males with acute lymphoblastic leukemia completing 24 to 30 months of maintenance chemotherapy in continuous remission. The 73 patients (10.3%) with occult testicular leukemia (TL) had a significantly increased risk of subsequent relapse (P = .0001) and death (P < .0001) when compared with patients with negative biopsies. Protocol-specified therapy for occult TL included reinduction therapy with concurrent bilateral testicular radiation, and 2 years of maintenance therapy. Four-year event-free survival for patients with negative biopsies was 78.2% ± 4% versus 65% ± 14% for patients with occult TL who received protocol-specified therapy (P = .05). This study suggests that (1) occult TL occurs in 10% of males completing 2 years of maintenance therapy; (2) occult TL significantly increases risk for subsequent relapse and death; (3) treatment results for occult TL and isolated overt off therapy TL (no previous biopsy) are similar; and (4) given current therapy, documentation of occult TL after 2 years of therapy does not improve disease-free survival.

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