Abstract
This investigation has the following scheme: Induction: vincristine (VCR)+daunorubicin+prednisone (PRED); CNS prevention: intrathecal methotrexate (MTX)+dexamethasone × 6 early doses followed by one trimesterly; and Continuation: 6-mercaptopurine daily and MTX twice weekly with reinforcement of pulse doses of VCR 1.5 mg/m2 × 1 + PRED 40 mg/m2/day × 7 (arm A) or VCR+PRED alternating with arab. cit. (Ara.C) 50 mg/m2/sc q. 12 h × 10 + cyclophosphamide (CTX) 600 mg/m2 × 1 (arm B). Pulses are performed in both arms at 1,2,3,4,6 mo, and trimesterly thereafter: In addition, half of the cases received levamisole (LEV) 120mg/m2/oral/daily and the other half, none.
From Jan. 1976 to Dec. 1978, 378 patients entered this study. 282/322 (88%) children and 44/56 (78%) adults achieved complete remission (CR) (P<0.05). The % of CR at 30 mo. are, arm A > 20.000 leukocytes 46%, > 20.000 37% and arm B > 20.000 78%, > 20.000 33% (P < 0.01 between and > 20.000 leukocytes in both arms and P < 0.05 between arms A and B in patients with > 20.000 leukocytes). In addition, 59% of the LEV-treated patients and 50% of the control group are still in the first CR at 30 mo. (P < 0.05).
We conclude that: 1) usefulness of alternating reinforcement pulses of VCR+PRED with Ara.C-CTX in relation to VCR+PRED alone, and 2) immunotherapy with LEV is effective in prolonging CR.
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Sackmann Muriel, F., Pavlosky, S., Bustelo, P. et al. 59 CONTINUATION THEFAPY IN ACUTE LYMPHOBLASTIC LEUKEMIA: EVALUATION OF DIFFERENT REGIMENS. Pediatr Res 15, 193 (1981). https://doi.org/10.1203/00006450-198102000-00116
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DOI: https://doi.org/10.1203/00006450-198102000-00116
