How does intrathecal chemotherapy help treat leukemia?

Hi,

Welcome to icliniq.com.

Acute lymphoblastic leukemia has a very high relapse rate in adults (about 60 %). The higher the white cell count, the worse the prognosis. Those with the Philadelphia chromosome (chromosomal abnormality) have a poor prognosis, andbonemarrow transplantation is required.

Relapsed cases with confirmed bone marrow biopsy require intensive chemotherapy aiming for achieving new remission, then either bone marrow transplantation or maintenance chemotherapy. I strongly advise consulting a physician for bone marrow stem cell transplantation.

I hope this helps.

Thank you.

Hi,

Welcome back to icliniq.com.

She most likely has a relapse focus in her brain as her bone marrow is free. In such cases, intrathecal (spinal) chemotherapy along with radiation of her brain (relapse focus) will be required. The prognosis depends on:

• The time between the first remission and first relapse (good if more than 18 months).
• The number of relapses (the higher, the worse).
• The presence of the Philadelphia chromosome.
• The response to the second course of chemotherapy.
• The total WBC (white blood cells). Please send me her last CBC (complete blood count).

Of course, radiotherapy will be beneficial, but bone marrow stem cell transplantation is a good option.

I hope this helps.

Thank you.

Hi,

Welcome back to icliniq.com.

I have checked the attached reports (attachment removed to protect patient identity). The CBC report results are within normal, which is a good sign. The brain MRI is suggestive of a brain relapse focus, which will require intrathecal chemotherapy and radiation therapy to the brain. Also, the report describes lesions that are a result of the past chemotherapy. The prognosis cannot be estimated; you should do your best and hope for the best.

I hope this helps.

Thank you.