Combination Chemotherapy for Marrow Relapse in Children and Adolescents with Acute Lymphocytic Leukaemia

Publisher Website
Google Scholar
Abstract
Thirty-eight children with acute lymphocytic leukemia (ALL) in hematologic relapse were retreated with vincristine, daunomycin and prednisone (VPD) together with intrathecal methotrexate and prednisone, followed by asparaginase in those patients not in complete remission after 4 wk. The overall complete remission (CR) rate was 79%; asparaginase was needed to achieve CR in 7 of the 30 responding patients. The median duration of 2nd remission was only 36 wk. Six of 15 children receiving the COAP[cyclophosphamide, vincristine, cytarabine, prednisone]-POMP[prednisone, vincristine, methotrexate, mercaptopurine]-CART [cytarabine, asparaginase, daunomycin, thioguanine] consolidation regimen remain in continuous 2nd remission after 37-260 wk; 3 of them are currently off all therapy. A prolonged 2nd remission apparently can be achieved in children with ALL in bone marrow relapse by combining intensive chemotherapy with the prevention of meningeal leukemia.