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Optimal use of L-asparaginase (NSC-109229) in acute lymphocytic leukemia

✍ Scribed by Jones, Barbara ;Holland, James F. ;Glidewell, Oliver ;Jacquillat, Claude ;Weil, Marise ;Pochedly, Carl ;Sinks, Lucius ;Chevalier, Louise ;Maurer, Harold M. ;Koch, Kjell ;Falkson, Geoffrey ;Patterson, Richard ;Seligman, Barbara ;Sartorius, Jurg ;Kung, Faith ;Haurani, Farid ;Stuart, Marie ;Burgert, E. Omer ;Ruymann, Frederick ;Sawitsky, Arthur ;Forman, Edwin ;Pluess, Hansjuerg ;Truman, John ;Hakami, Nasrollah

Book ID
102949965
Publisher
John Wiley and Sons
Year
1977
Tongue
English
Weight
800 KB
Volume
3
Category
Article
ISSN
0098-1532

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✦ Synopsis

Abstract

Between 1971 and 1974, 646 evaluable patients under 20 years of age with previously untreated acute lymphocytic leukemia were treated according to Cancer and Leukemia Group B (formerly Acute Leukemia Group B) Protocol 7111. On a random basis, they received a 10‐day course of 1,000 units/kg/day of L‐asparaginase before, during, or after a 3‐week course of vincristine and corticosteroid. A control group received vincristine and corticosteroid for 4 weeks but no asparaginase. The overall complete remission rate was 85%, which was not altered significantly by any of the induction variables. Patients who received asparaginase for 10 days subsequent to vincristine and corticosteroid had a significantly longer complete remission duration with an estimated median of 45 months, compared to 20 months for the group receiving no asparaginase and 27 months for the other 2 asparaginase regimens. The beneficial effect of asparaginase was noted, irrespective of which 1 of the 2 intensification and maintenance programs the patients received. The 5‐year projection indicates a complete remission rate of 50% for those patients receiving subsequent asparaginase as compared to 41% of those induced on other regimens in this study and thus is superior to the use of only vincristine and corticosteroid.

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