Improved survival in young children with acute granulocytic leukemia treated with combination therapy using cyclophosphamide, oncovin, cytosine arabinoside, and prednisone

Madanat, Faris; Sullivan, Margaret P.

doi:10.1002/1097-0142(197909)44:3<819::aid-cncr2820440305>3.0.co;2-c

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…Thus, the teenage patient and the infant with ANLL have a reduced chance for ultimate survival. Another recent study showed that seven of 17 children under 5 years with acute granulocytic leukemia treated with either cytosine arabinoside-cytoxan combination or cytosine arabinoside, cytoxan, vincristine, and prednisone have remained in continuous remission for 4 years or more, whereas only one of 24 over age 6 years is still in remission [7]. A previously unrecognized factor influencing remission duration identified in this analysis of Childrens Cancer Study Group data was the duration of time to achievement of an M1 marrow.…”

Section: Discussionsupporting

confidence: 92%

Characteristics of children with acute nonlymphocytic leukemia in long‐term continuous remission: A report for childrens cancer study group

Baehner¹,

Kennedy²,

Sather³

et al. 1981

Med. Pediatr. Oncol.

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Children and young adults less than 18 years of age with acute nonlymphocytic leukemia who remained in long term bone marrow and extramedullary remission for two years or longer since starting maintenance were compared to the remaining responders for the following characteristics: cell type, sex, age at diagnosis, race, pretreatment, white blood count, length of time from start to induction therapy to achievement of an M1 marrow, marrow rating at day 56 of therapy, marrow rating at the start of maintenance therapy, and specific study. Forty-eight patients of a group of 333 qualified as having long term remission (14.4%). Multivariant analysis indicated that patients between the ages of 3 and 10 years (p = 0.003) as well as the length of time to achieve an M1 marrow from the start of treatment (p = 0.03) were the only characteristics associated with achievement of a long term remission. Maintenance therapy was discontinued in 15 patients from 2.5 to 4.8 years after start of maintenance and all patients remained in bone marrow remission of periods from 0+ to 3.0+ years after stopping treatment. Of the 33 who have remained on a continuous maintenance therapy 12 have had bone marrow relapses. These data confirm the prognostic value of age and length of time to achieve remission during induction in acute nonlymphocytic leukemia and suggest that there may be no significant benefit from maintenance therapy continued beyond 2 years for patients in their initial remission.

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Section: Discussionsupporting

confidence: 92%

Characteristics of children with acute nonlymphocytic leukemia in long‐term continuous remission: A report for childrens cancer study group

Baehner¹,

Kennedy²,

Sather³

et al. 1981

Med. Pediatr. Oncol.

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“…In children and young adults remission rates for ALL are in the range of 9Ov0, while for AML occurring in the same age range, remission rates have been reported to be65-78Vo [l-51. In addition, while the proportion of long term remissions in young individuals with ALL is substantial this has not been the case for A.ML where median durations of remission are generally reported to be 8-12 months (1)(2)(3)(4)(5)(6)(7). The present report summarires our 6 year experience with treating children and young adults with AML.…”

Section: Introductionmentioning

confidence: 62%

The treatment of acute myelocytic leukemia in patients 30 years of age and younger

et al. 1982

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The treatment of acute myelocytic leukemia in childhood and young adults has lagged behind that for acute lymphocytic leukemia. The studies described here were directed towards evaluating the role of intensive chemotherapy in the treatment of this illness. Intensive remission induction therapy combining cytosine arabinoside with an anthracycline antibiotic produced a complete remission rate comparable to that achieved in acute lymphocytic leukemia (45 of 49 patients or 92%). Intensive consolidation chemotherapy produced a median duration of complete remission of 160 weeks with 40% of patients projected to be in remission at 4 years. By contrast, the median duration of remission for patients treated with moderate consolidation/maintenance therapy was 23 weeks with only 10% of patients in remission at 4 years. These studies demonstrate that intensive chemotherapy can be administered to pediatric patients and young adults and that this approach to therapy produces a high remission rate with a 3 year median duration of remission.

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“…The tumor develops at various stages of nonlymphocytic leukemia with a reported frequency ranging from 2.9 to 6.8% [2,9,12]. Major progress in the treatment of ANLL has occured during the past decade; more than 25% of children with ANLL have been in initial complete remission for two years with intensive therapy [13][14][15][16]. Thus, the actual frequency of granulocytic sarcoma is probably higher than reports suggest.…”

Section: Discussionmentioning

confidence: 99%

“…Follow-up CT scan of the brain showed marked dilatation of the cortical sulci and focal area of atrophy of the brain (June13, 1985).…”

mentioning

confidence: 99%

Therapeutic modalities for central nervous system involvement by granulocytic sarcoma (chloroma) in children with acute nonlymphocytic leukemia

et al. 1987

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Four cases of central nervous system involvement by granulocytic sarcoma (three intracranial and one paraspinal) in children with acute nonlymphocytic leukemia (FAB M1 or M2 subtype) are presented, and therapeutic modalities are discussed. All tumors were noted at initial presentation with diagnosis being made on clinical and radiological findings without biopsy. All patients had karyotypic abnormalities: three had translocation of chromosomes 8 and 21, and one had an unspecified hypodiploid clone. The three patients who developed intracranial tumors responded well to triple agent (cytosine arabinoside, hydrocortisone, and methotrexate) intrathecal chemotherapy and systemic chemotherapy, with or without local irradiation, as evidenced by rapid disappearance of the tumors. Two children are disease-free after 17 and 57 months. One patient with paraspinal tumor failed to achieve a systemic remission but had no evidence of granulocytic sarcoma at autopsy. Thus, the prognosis of CNS granulocytic sarcoma is not uniformly gloomy if treated aggressively by combined modalities. The value of surgical intervention in terms of primary management, however, is limited.

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Improved survival in young children with acute granulocytic leukemia treated with combination therapy using cyclophosphamide, oncovin, cytosine arabinoside, and prednisone

Cited by 10 publications

References 13 publications

Characteristics of children with acute nonlymphocytic leukemia in long‐term continuous remission: A report for childrens cancer study group

Characteristics of children with acute nonlymphocytic leukemia in long‐term continuous remission: A report for childrens cancer study group

The treatment of acute myelocytic leukemia in patients 30 years of age and younger

Therapeutic modalities for central nervous system involvement by granulocytic sarcoma (chloroma) in children with acute nonlymphocytic leukemia

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