RESULTS OF AGGRESSIVE CHEMOTHERAPY FOR ACUTE NONLYMPHOBLASTIC LEUKEMIA IN ADULTS

  • 1 January 1982
    • journal article
    • research article
    • Vol. 66  (11) , 1917-1924
Abstract
Sixty-five patients with acute nonlymphoblastic leukemia, ranging in age from 16-73 yr (median, 54 yr), were treated with thioguanine, cytarabine, daunorubicin, prednisone and vincristine to induce complete remission. Remission was maintained with monthly 5-day courses of cytarabine and thioguanine, for 4 yr. Of the entire group, 57% achieved complete remission and 29% died in the 1st 30 days of treatment. The median remission duration was 15 mo. with 20% of the complete responders predicted to remain in complete remission for 4 yr. No primary CNS relapses have occurred. Of 6 variables examined by multivariate analysis, only age was predictive of remission success. Before analysis, the patients were divided into the following groups by age: group 1-ages 16-42 yr (n = 17); group 2-ages 43-59 yr (n = 25); and group 3-ages 60-73 yr (n = 23). Complete remission rates were 76% in group 1, 64% in group 2 and 35% in group 3 (P = 0.002). Lower remission rates for older patients resulted from more early deaths rather than resistant disease. Age and LDH [lactic dehydrogenase] levels affected remission duration. The median complete remission duration was 48 mo. in group 1 and 10 mo. in groups 2 and 3 (P = 0.004). In group 1, 41% of patients achieving complete remission are predicted to remain in complete remission for 4 yr. This 5-drug induction regiment apparently is highly effective for induction therapy in younger adults with acute nonlymphoblastic leukemia. The results in patients .gtoreq. 60 yr of age are less satisfactory due to a lower remission rate and greater chance of early death. The program as described results in a longer duration of complete remission for patients of younger age.