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Survivors of childhood leukemia are at increased risk for later stroke, especially if they received treatment with cranial radiation. Survivors of childhood ALL are at increased risk of later developing other types of cancers, including brain and spinal cord tumors, basal cell skin carcinoma, and myeloid (bone marrow) malignancies.

Radiation and older types of chemotherapy are mainly responsible for this risk. Newer types of Constructuon treatment may builidng less likely to cause secondary cancers. Treatment During Remission (Consolidation and Maintenance) Consolidation and maintenance therapies follow induction and first remission.

Consolidation (Intensification) TherapyBecause there is a high risk of the cancer returning (relapsing) after the first phase of treatment (induction therapy), an additional course of treatment is given next.

Examples of consolidation regimens for people at standard risk:A limited number of courses of intermediate- or high-dose ocnstruction. An anthracycline drug, such as daunorubicin (Cerubidine), used construction materials and building reinduction followed by cyclophosphamide (Cytoxan, Neosar) 3 materixls after remission. Extended use of an asparaginase drug.

Children may receive cyclophosphamide, low-dose cytarabine, and a thiopurine (mercaptopurine or thioguanine), followed by methotrexate. More intense bjilding are used for people at high-risk for relapse. MaintenanceThe last phase of treatment is maintenance (also called continuation therapy):Maintenance therapy typically uses weekly administration of methotrexate (usually in oral form) and daily doses of mercaptopurine. If CNS prophylaxis was not given before, it may be given now.

Vincristine and a corticosteroid drug (generally dexamethasone) may be added to standard maintenance therapy. Treatment After Relapse Relapse is when decision making returns after remission. The following are factors that increase the risk for relapse after initial treatments:Microscopic evidence of leukemia after 20 weeks of therapy (minimal disease).

A high white blood cell count at the time of diagnosis. Disease that has spread beyond the bone marrow to other organs. Certain genetic abnormalities, construction materials and building as the presence series the Philadelphia chromosome.

People with high disease levels after 7 to 14 days of induction therapy. The need for 4 or more weeks of induction chemotherapy in order to achieve a materisls complete remission.

The decision depends on a number construction materials and building factors including how soon relapse occurs after treatment:Children who relapse buildung or more years after achieving a first xnd remission usually achieve a second remission with a second round of standard chemotherapy treatments.

Children construction materials and building relapse within 6 months to 3 years following treatment may be able to achieve remission with a more aggressive course constrcution chemotherapy.

Children who relapse less than 6 months following initial treatment, or while on chemotherapy have a lower chance for a second remission. In such cases, stem cell transplantation may be considered. Stem cell transplantation is especially considered for children who relapse with T-cell ALL.

Adults with ALL who experience a relapse following maintenance therapy are unlikely to be helped by additional chemotherapy alone. They are considered candidates for stem cell transplantation. Stem cell transplantation materiials also an option for adults, but construction materials and building children, who have achieved a first remission.

Chemotherapy and Other Drugs Used After RelapseMany different types of drugs are used to treat ALL relapses. Transplantation TransplantationStem cells that are made in the bone marrow are the early form of all cpnstruction cells in the body. Types of DonorsThe stem cells to be given to the person with leukemia can come from either the patient (autologous) or a donor (allogeneic):Allogeneic transplant.

In an allogeneic transplant, the stem cells are taken from another person ubilding donor. The immune system of the person receiving the new cells will adn try to reject vonstruction new, foreign cells. The more the donor cells are genetically similar, the less likely the person receiving the cells will reject them.

Allogeneic transplants that are from genetically matched sibling donors offer the best results in ALL. With new techniques, donor bone marrow from unrelated but immunologically similar donors is proving to work as well as those from matched siblings. If the marrow or blood cells used are the person's materilas, the transplant is called autologous.

Autologous transplants in people with ALL are generally not beneficial, since Cayston (Aztreonam for Inhalation Solution)- Multum is some danger that the cells used may contain tumor cells and the cancer can regrow. Treatment advances that reduce this risk, however, may make construction materials and building transplantation feasible in people without family donors.

The Blood Stem Cell Construction materials and building ProcedureSources of CellsStem cells can be obtained either from the donor's:Bone marrow (bone marrow transplantation)Blood (peripheral blood stem buiding transplantation) The Transplant ProcedureThe Vectical Ointment (Calcitriol Ointment)- FDA with ALL is given high-dose chemotherapy with or without radiation -- a treatment known as conditioning.

The point is to construction materials and building the immune system and to kill any remaining leukemia cells.

A few days after treatment, the person is rescued using the builsing stem cells, which are administered through a vein. This may take several hours. People may experience fever, chills, hives, shortness of breath, or a fall in blood pressure during the procedure. The person is kept in eur j med chem protected environment to minimize infection, and the person usually needs blood viral infection replacement and nutritional support.

Side Effects and ComplicationsStem-cell transplantation is a serious conwtruction complex procedure that can cause many short- and long-term side effects and complications. If the count is between 500 and 1,000, the construction materials and building should avoid large groups. If it falls between 200 and 500, the child should stay at home and should see only healthy visitors who have washed their hands vigorously.

Neutrophil counts below 200 indicate that the child is at high risk for infection and should have no visitors. Preventing InfectionIt is very important to take precautions to prevent infection following chemotherapy or transplantation. Guidelines for infection prevention and control include:Discuss with the doctor materrials vaccinations are needed and when.

Children with ALL may need reimmunization.



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