Therapie der akuten Lymphoblastenleukämie im Kindesalter Multizentrische prospektive Therapiestudie COALL-80

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Abstract
Since 1979 in a cooperative study (COALL-80), 110 children with acute lymphoblastic leukemia (ALL) and 13 children with high grade malignant non-Hodgkin''s lymphoma (NHL) were treated with a less aggressive modification of the West Berlin Study Program BFM 76/79. [The protocols tested used methylprednisolone, vincristine, daunorubicin, asparaginase, cyclophosphamide, cytosine arabinoside, methotrexate, 6-mercaptopurine and 6-thioguanine.] Asparaginase was delayed from the initial 4-drug regimen and interposed between induction therapy and treatment of the CNS. Induction therapy given that way was well tolerated and usually feasible on an outpatient basis. The expected 2.5 yr disease-free survival rate for ALL is 86% and no worse than the results of the original BFM study. It was possible to define by age (> 2, < 7 yr), initial blast count (< 2500/mm3) and immunological typing (cALL Ag+) a group of patients (52%) which has remained in continuous remission. For this group further reduction of therapy intensity is planned (omission of cyclophosphamide during the CNS-phase and use of intermediate dose methotrexate instead of CNS-irradiation).