High‐dose cytarabine in upfront therapy for adult patients with acute lymphoblastic leukaemia

Open Access
Publisher Website
Google Scholar
Abstract
Summary. In this national study, we have evaluated a new intensive chemotherapy protocol for adult patients with untreated acute lymphoblastic leukaemia (ALL). One hundred and fifty‐three patients with median age 42 years received induction therapy with high‐dose cytarabine (Ara‐C), cyclophosphamide, daunorubicin, vincristine and betamethasone. A high complete remission (CR) rate (90%) was achieved in patients < 60 years compared with 70% in patients > 60 years (P = 0·004). The estimated 3 year overall survival for all patients was 29% (CI 21–36%) and the estimated continuous complete remission (CCR) at 3 years for the patients achieving CR according to the protocol was 36% (CI 27–45%). A favourable pretreatment characteristic was pre‐B phenotype, especially for patients < 40 years without any high‐risk factor, with an estimated CCR at 3 years of 62% (CI 41–82%). Stem cell transplantation (SCT) as post‐remission therapy, mainly for high‐risk patients, gave an estimated 3 year disease free survival (DFS) after SCT of 39% (CI 24–54%). No significant differences in DFS could be found between autologous, related or unrelated donor transplantation. We conclude that this intensive protocol resulted in a high CR rate combined with acceptable side‐effects and a favourable CCR for patients with pre‐B ALL.

This publication has 25 references indexed in Scilit: