The Comparison of 6-Mercaptopurine with the Combination of 6-Mercaptopurine and Azaserine in the Treatment of Acute Leukemia in Children: Results of a Cooperative Study

Abstract

The results of the first study of the Leukemia Chemotherapy Cooperative Study Group A for the evaluation of two treatment programs in acute leukemia are reported. The cases were accumulated in a period of 15 months. One hundred and twenty-five of the 168 patients started on the study were considered adequately treated and suitable for analysis. The 43 cases excluded from evaluation consisted of patients whose therapy was changed to steroids, those expiring while on treatment, and those lost for follow-up or drug errors. In 125 cases of previously untreated acute leukemia in children, no significant difference was seen in the percentage of complete remissions obtained when 6-mercaptopurine was used alone or when 6-mercaptopurine and azaserine were used in combination. The duration of the remissions obtained with the combined therapy was not significantly longer than when 6-mercaptopurine was used alone.

The Planniing and Problems of Clinical Trials

“…American workers have used a precise numerical system (Bisel 1956) for recording the response to treatment in terms of its capacity to relieve symptoms, to influence signs, and to induce changes in the peripheral blood and bone marrow. This system is of great value in assessing the remission rate in childhood leukemia (Heyn et al 1960) but has been difficult to apply to acute leukemia in adults, for which we are still seeking a satisfactory method of classifying the results of treatment.…”

Improving the outcome for children with cancer: Development of targeted new agents

“…The first NCI cooperative group focused on childhood leukemia research. 12 The success of the cooperative group model spawned the establishment of several groups in both pediatric and medical oncology. By the end of the 1990s, there were 4 groups focused on childhood cancer: 2 were disease-specific (the Pediatric Oncology Group and the Children's Cancer Group), and 2 were disease-centric (the National Wilms Tumor Study Group and the International Rhabdomyosarcoma Study Group).…”

“…The US National Cancer Institute (NCI) had a central role in funding a research infrastructure for the conduct of a breadth of clinical trials, an infrastructure that dates back to the 1950s. The first NCI cooperative group focused on childhood leukemia research . The success of the cooperative group model spawned the establishment of several groups in both pediatric and medical oncology.…”

The successful integration of research and care: How pediatric oncology became the subspecialty in which research defines the standard of care

“…While CALGB focused on adult and pediatric leukemia, ALCCSGA, directed by Dr. Joseph H. Burchenal and Dr. Mary Lois Murphy of MSK, was a purely pediatric cooperative group. Early randomized trials in ALL were simultaneously conducted in 1955 by ALCCSGA 41 and by the pediatric division of CALGB 24. By 1965, in addition to leukemia, group studies included Wilms tumor and acute nonlymphoblastic leukemia 42.…”