Increased survival in childhood acute nonlymphocytic leukemia after treatment with prednisone, cytosine arabinoside, 6-thioguanine, cyclophosphamide, and oncovin (PATCO) combination chemotherapy

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Abstract
Children [163] with acute nonlymphocytic leukemia (ANLL) were treated with a multiple-drug induction program (PATCO) consisting of prednisone (PDN), cytosine arabinoside (Ara-C), 6-thioguanine (6-TG), cyclophosphamide (CPM) and Oncovin (VCR). Ninety-six patients, 59%, obtained a remission. Remission was maintained with daily 6-TG and 4 day pulses of Ara-C and CPM with a single dose of VCR every 28 days. The median duration of remission was 11.5 mo. Certain prognostic factors affected induction rate and remission duration. Initial white blood count (WBC) was a significant factor in achieving a remission, whereas age, sex and type of ANLL had no effect. Initial WBC, age and sex had a significant effect on remission duration, but type of ANLL had no effect. Relapsing patients were treated with daunomycin and 5-azacytidine. The reinduction rate was 53% with a median 2nd remission duration of 190 days. Overall survival for the 163 patients is 55.4% at 12 mo., 31.5% at 24 mo., 21.4% at 36 mo. and 19% at 48 mo.