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Treatment intensity and outcome for children with acute lymphocytic leukemia of standard risk. A pediatric oncology group study

โœ Scribed by Jan van Eys; Daisilee Berry; William Crist; Ed Doering; Donald Fernbach; Jeanette Pullen; Jon Shuster


Publisher
John Wiley and Sons
Year
1989
Tongue
English
Weight
485 KB
Volume
63
Category
Article
ISSN
0008-543X

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โœฆ Synopsis


Four hundred thirty-four children, with good-risk acute lymphocytic leukemia (ALL), were assigned randomly to receive intensive or less intensive maintenance therapy with 6-mercaptopurine and methotrexate, plus vincristine and prednisone pulses in such a way that patients on treatment 1 had their leukocyte counts maintained between 1500 and 3000/mm3. Patients on treatment 2 had leukocyte counts maintained between 3000 and 4500/mm3. Absolute granulocyte counts were maintained above 90/mm3 on both groups. All children received induction treatment with vincristine, prednisone and Gasparaginase and had central nervous system (CNS) prophylaxis with cranial irradiation and intrathecal methotrexate. The overall remission rate was 94%. Event-free survival at 8 years was 44% (SE, 5.6%). There was no significant difference in outcome between treatments 1 and 2 (P = 0.83). The incidence of infection was similar overall and not significantly different between treatment arms.


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## Background: Children with acute lymphoblastic leukemia (all) who experience hematologic recurrence while receiving chemotherapy or within 6 months after its cessation have a low cure rate. in this study (pediatric oncology group protocol 8303) two methods were examined for improving the outcome