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Treatment of acute lymphoblastic leukemia in children. Long-term results of two trials.
- Source :
-
Neoplasma [Neoplasma] 1983; Vol. 30 (1), pp. 81-92. - Publication Year :
- 1983
-
Abstract
- Eighty-eight children younger than 15 years with acute lymphoblastic leukemia were treated with two similar protocols. Both regimens consist of multidrug combinations, with CNS prophylaxis. Sixty-four patients were enrolled on first protocol 0171 with vincristine and prednisone induction therapy. After remission induction patients were randomized on two arms: regimen A which consists of intensive courses of methotrexate with vincristine and prednisone reinductions and administration of cyclophosphamide. Regimen B is similar to regimen A, only courses of methotrexate are alternated with courses of 6-mercaptopurine during consolidation and intensification therapy. In maintenance phase both regimens have daily administration of 6-mercaptopurine and twice weekly administration of methotrexate, with vincristine and prednisone reinductions. The second protocol 0276/A is similar to regimen B of protocol 0171, but L-asparaginase is administered in the end of induction phase and total duration of therapy since induction of complete remission is prolonged from 2.5 to 4 years. Complete remission rate ranged from 92 to 96% in the patients achieving complete remission. In protocol 0171 actuarial proportion of children alive in complete remission for more than 10 years is 60% at present. The actual median survival of all children treated with protocol 0171 is 46+ months and actual median duration of complete remission is 43+ months. There was no significant difference between patients treated with methotrexate alone and those treated with combination of methotrexate and 6-mercaptopurine during consolidation and intensification phase. In protocol 0171 the relapse rate was 28% and the death rate in complete remission was 15%. More than 70% of complete responders in protocol 0276 is in continuous complete remission from 2+ to 57+ months, relapse rate is only 4% at present and the death rate in complete remission is 9% in this protocol.
- Subjects :
- Adolescent
Antineoplastic Agents adverse effects
Child
Child, Preschool
Clinical Trials as Topic
Drug Administration Schedule
Drug Therapy, Combination
Female
Humans
Infant
Leukemia, Lymphoid mortality
Leukocyte Count
Lymphocytes pathology
Male
Random Allocation
Recurrence
Antineoplastic Agents administration & dosage
Leukemia, Lymphoid drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0028-2685
- Volume :
- 30
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Neoplasma
- Publication Type :
- Academic Journal
- Accession number :
- 6339961