Intensive retreatment of adults and children with acute lymphoblastic leukemia

✍ Scribed by Renato Bassan; Pier Emilio Cornelli; Raffaele Battista; Fausto Terzi; Maurizio Buelli; Alessandro Rambaldi; Piera Viero; Anna D'Emilio; Enrico Dini; Tiziano Barbui

• Publisher: John Wiley and Sons
• Year: 1992
• Tongue: English
• Weight: 412 KB
• Volume: 10
• Category: Article
• ISSN: 0278-0232
• DOI: 10.1002/hon.2900100206

✦ Synopsis

Twenty-three patients (16 adults) failing their first or subsequent (n = 8) intensive treatment for de nuvo acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia lymphoid blast phase (n = 2) were managed with protocol POG 8201, originally introduced in relapsed ALL of childhood. In this programme, a four-drug induction phase is followed by early consolidation with teniposide-cytarabine, intrathecal chemotherapy, continuation weekly chemotherapy alternating teniposideecytarabine with vincristine-cyclophosphamide, and periodic reinduction courses. Fourteen adults and five children with ALL achieved a complete response (CR) (86 per cent). The highest response rate (100 per cent) was obtained in 12 patients treated at first relapse after an initial CR of greater than 18 months (p = 0.07). Median duration of CR was 8 months in adults and 1 1 months in children. A longer than previous one CR (inversion) was obtained in four cases. Four ALL patients were successfully transplanted from a matched sibling after 3-1 1 months from achievement of CR. Median overall survival in adults with ALL was 1 1 months, significantly longer than for 40 comparable cases treated intensively but without rotational continuation therapy in previous years (p < 0.00 I). This regimen is applicable to adults with relapsed ALL, where prolongation of survival may allow time for effective salvage with bone marrow transplantation.