What is the role of radiation therapy in pediatric acute myelocytic leukemia (AML) treatment?

Updated: Sep 12, 2017
  • Author: Mark E Weinblatt, MD; Chief Editor: Jennifer Reikes Willert, MD  more...
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Answer

Radiation treatment is primarily used to treat chloromas and other masses that are pressing on a vital structure and that may imminently cause irreversible damage. Examples include spinal cord compression and superior vena cava syndrome or airway compromise due to mediastinal masses. Corticosteroids and early administration of chemotherapy can effectively relieve most of these complications.

Persistent CNS leukemia usually requires craniospinal irradiation.

Most pretransplantation myeloablative regimens given to children in their first complete remission have replaced total body irradiation with busulfan to decrease the incidence of some long-term adverse effects (ie, growth retardation, brain tumors). Although busulfan is associated with significant, potential, short-term and long-term adverse effects (including seizures and infertility), the incidence of second malignancies is lower than that associated with total body irradiation.


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