Combination chemotherapy of adult acute lymphocytic leukemia

Smyth, A.; Wiernik, Peter H.

doi:10.1002/cpt1976192240

Cited by 21 publications

(6 citation statements)

References 2 publications

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“…figure is apparently based on unpublished data from ALGB on 13 adults with ALL over the age of 20 years [8,9,20], and from unpublished data from St. Bartholomew's Hospital in London where 15 of 32 adults (47Vo) with ALL achieved a CR with VCR + In the present study, the CR rate of 66% is comparable to the overall figure from the literature of 61%. When a third agent, either doxorubicin or cytosine arabinoside, was added to the induction regimen in those patients who failed to achieve…”

supporting

confidence: 74%

Results of induction therapy with vincristine and prednisone alone in adult acute lymphoblastic leukemia: Report of 43 patients and review of the literature

Hess

Zirkle

1982

American J Hematol

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The complete remission (CR) rate in children with acute lymphoblastic leukemia (ALL) who received vincristine (VCR) plus prednisone (PRED) alone for induction is > 90%, and has not improved with the use of more intensive regimens. In adults with ALL, using the same regimen, a CR rate of only 50% is frequently quoted, and is apparently based mainly on unpublished data on only 13 patients from an early Acute Leukemia Group B protocol. We reviewed the case records of 43 adults with previously untreated ALL seen between July I , 1966 and December 3 I , 1978 who received VCR + PRED alone for induction. A CR rate of 66% was achieved and compares to an overall figure of 61% from 162 patients collected from the literature. The CR rate was age dependent with 21/29 (76%) < 50 years of age achieving a CR compared to 4/19 (29%) who were 2 50 years of age (P < 0.02). The median duration of CR was 8.3 months. For those who achieved a CR, the median survival was 19 months compared to five months for those who either failed to achieve a CR or who achieved only a partial remission (P = 0.004). All patients who achieved a CR received maintenance therapy, and approximately one-half also received CNS prophylaxis with intrathecal methotrexate. The incidence of isolated CNS relapse was 1 1 % in those who received CNS prophylaxis compared to 20% in those who did not.From these data and a review of the literature, we conclude that approximately twothirds of adults with ALL will achieve a CR with the use of VCR + PRED alone. The median duration of CR, however, is < one ycar and the median survival is approximately two years. Whether the use of more intensive induction, consolidation, and maintenance regimens will improve these results remains to be established.

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supporting

confidence: 74%

Results of induction therapy with vincristine and prednisone alone in adult acute lymphoblastic leukemia: Report of 43 patients and review of the literature

Hess

Zirkle

1982

American J Hematol

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“…The results of adult ALL treatment with many combinations are very similar to obtained complete remission. However, the duration of complete remission and survival period is better with the regimen here described (Table II) [19][20][21][22].…”

Section: Discussionmentioning

confidence: 99%

Treatment of adult acute lymphoblastic leukemia with adriamycin, vincristine, and prednisone

Avilés¹,

Sinco²,

Rivera³

et al. 1983

Med. Pediatr. Oncol.

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At the present time, it is possible to achieve up to a 95% complete remission in childhood acute lymphoblastic leukemia, using the combination of vincristine and prednisone. Nevertheless, it has not been possible to reproduce these results in the adult. For this reason, a third drug, in this case adriamycin in a low dose, was added to the vincristine-prednisone combination in the treatment of adult acute lymphoblastic leukemia (ALL). Complete remission was achieved in 45 of the 50 patients (90%). The median duration of remission was 23 months and the median survival time in this group was 31 months. The complications were minimal and the tolerance was good. From the point of view of our results and others reported in the literature, we consider that the combination of vincristine, prednisone, and adriamycin is a useful method for induction of remission of adult ALL.

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“…Single-agent maintenance chemotherapy extends remission duration, to 7 months in one report, but long-term survivors are few (6). Intermittent chemotherapy with remission induction agents has been relatively ineffective in prolonging remissions according to 2 reports (7,8). In one of these studies, the same drugs in combination with immunotherapy tripled remission duration (7).…”

Section: Discussionmentioning

confidence: 99%

Remission maintenance of adult acute lymphoblastic leukemia

Armitage

Burns

1977

Med. Pediatr. Oncol.

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This report describes the results of a study of central nervous system (CNS) prophylaxis and combination chemotherapy for the maintenance of remission in adult acute lymphoblastic leukemia. Adults with acute lymphoblastic leukemia who achieved complete remission were treated with 2,400 rads cranial irradiation and intrathecal methotrexate for CNS prophylaxis followed by continuation systemic chemotherapy with oral methotrexate, 6-mercaptopurine and cyclophosphamide. There were no CNS relapses following treatment. One-half of the patients relapsed within 11 months, with 5 patients remaining in remission for 27+ to 31+ months. The toxicity was acceptable with no treatment-related deaths. This regimen is capable of producing long remissions in a significant proportion of adults with acute lymphoblastic leukemia and appears to be effective in reducing the incidence of CNS relapse. It has the additional advantage of ease of administration and can be largely administered in the community.

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Combination chemotherapy of adult acute lymphocytic leukemia

Cited by 21 publications

References 2 publications

Results of induction therapy with vincristine and prednisone alone in adult acute lymphoblastic leukemia: Report of 43 patients and review of the literature

Results of induction therapy with vincristine and prednisone alone in adult acute lymphoblastic leukemia: Report of 43 patients and review of the literature

Treatment of adult acute lymphoblastic leukemia with adriamycin, vincristine, and prednisone

Remission maintenance of adult acute lymphoblastic leukemia

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