Treatment of acute lymphoblastic leukaemia

Abstract

Case history: P.T. was an 8 year old child complaining of lassitude, tiredness, anorexia and loss of weight. Admitted on 2/4/69. Past history: Chicken pox, mumps and measles. Family history: Nothing relevant. On examination the patient was anaemic, and had scattered non-tender glands in the axillae and small haemorrhages on the hard palate. Pulse 90 regular. JVP:O. B.P. 120/80. Soft systolic ejection murmur maximal at the apex. Chest clinically clear. Firm hepatic enlargement (2 fingers) and palpable spleen. CN.S. : N.A.D. Marrow punture revealed acute lymphoblastic leukemia; 50% ot the cells were blasts. Blood: Hb. 6.2 gm., platelets 206,000, WBC 4,900. He was started on the MRC regime for acute lymphoblastic leukaemia using Prednisone, Vincristine, 6-Mercaptopurine, Methotrexate, Asparaginase and Folinic acid. These were given according to a planned pattern and stopped 21 weeks after immunotherapy by BCG was started; the BCG was given weekly and the patient has remained in remission for 2 years. In acute leukaemia there is an accumulation of malignant colonies of abnormal blast cells in the bone marrow and other tissues resulting in poor red cell, platelet and granulocyte production and leading to a fatal result if left untreated.