Among 164 patients with acute lymphoblastic leukemia (ALL) (age > 11 years) induced into complete remission at four hospitals in Italy and The Netherlands between 1971-1977, 49 survived for more than three years in continuous complete remission. Features at diagnosis of the 49 long-term survivors were compared with those of the parent group. The long-term survivors presented with significantly lower leukocyte counts and were slightly younger. Late relapses occurred in nine patients after 37-91 months from remission. Of the 45 patients who had all treatment stopped after 24-60 months of continuous remission, seven have relapsed. Relapses, mainly in the marrow, occurred 4-32 months after cessation of therapy, the risk of relapse being greatest in the first year and dropping to zero by the fourth year. ALL appears curable in approximately one fifth of adolescents and adults entering complete remission with adequate chemotherapy.
Cancer 52~30-34, 1983.
HEREAS there is no longer any doubt that the in-W troduction of effective chemotherapy, coupled
with the prevention of central nervous system (CNS) leukemia, has dramatically improved prognosis in childhood acute lymphoblastic leukemia (ALL), there has been much less progress in the treatment of ALL in adults. Although ALL in adults responds to the same drugs used successfully in the disease in childhood, lower response rates and shorter durations of remission and survival have been the rule.'.2 However, in recent years, several authors have reported an increasing proportion of long-term survivors, suggesting that some patients can be In an attempt to identify factors characteristic of long-term survivors, we studied a group of 49 patients (age > 11 years) with ALL, all of whom had survived for at least three years in continuous initial remission. Furthermore, the results of cessation of treatment in 45 long-term survivors were analyzed to determine the incidence of relapse off therapy.