CHEMOTHERAPY FOR ACUTE MYELOGENOUS LEUKEMIA IN CHILDREN AND ADULTS - VAPA UPDATE

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  • 1 January 1983
    • journal article
    • research article
    • Vol. 62  (2) , 315-319
Abstract
A protocol (VAPA) was designed that featured 14 mo. of intensive postremission induction chemotherapy [vincristine, doxorubicin, prednisolone, cytosine arabinoside] in an effort to improve remission durations for patients with acute myelogenous leukemia (AML). Patients (107) under 50 yr of age were entered into this study. The rate of complete remission is 70%. A Kaplan-Meier analysis of patients entering remission predicts that 56% .+-. 7% (.+-. SE) of patients less than 18 yr and 45% .+-. 9% of patients aged 18-50 yr will remain in remission at 3 yr (median follow-up is 43 mo.). Patients with the monocytic subtype had a statistically significant shorter duration of remission (2-sided P < 0.05). There was a high incidence of primary CNS relapse in children. Of 41 patients who completed the regimen 31 remain in remission without maintenance therapy. The VAPA protocol continues to offer a promising approach to treatment of AML.