Milpied, Noel, Gisselbrecht, Christian, Harousseau, Jean-Luc, Sebban, Catherine, Witz, Francis, Troussard, Xavier, Gratecos, Nicole, Michallet, Mauricette, LeBlond, Veronique, Auzanneau, Gerard, and Fiere, Denis
The success rate in the treatment of adults with acute lymphoblastic leukemia is far from satisfactory; only 25 to 40 percent of patients treated with initial chemotherapy may be expected to achieve long-term survival. Among those who relapse, less than half may be expected to achieve remission a second time, and few of these patients will survive. Various drugs are known to be effective against leukemia, albeit at high doses. In an attempt to improve the success of treating relapsed patients, a combination treatment was designed to include four different anti-leukemic drugs, each at its optimum efficacy-to-toxicity ratio. Forty-three adult patients with relapsed or unresponsive acute lymphoblastic leukemia were treated with a combination of prednisone, cytarabine, mitoxantrone, and etoposide. The combination, dubbed PAME, produced a complete remission in 30 of 43 patients. The median duration of the remission was short for these patients, however, at four months, and the median overall survival for the patients achieving complete remission was seven months. (Consumer Summary produced by Reliance Medical Information, Inc.)