Treatment of acute lymphoblastic leukaemia in adults

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Abstract
Summary.Between 1972 and 1982, 112 consecutive previously untreated adults (aged 15–69 years, median 26) commenced therapy for acute lymphoblastic leukaemia (ALL) at St Bartholomew's Hospital. The first 63 patients entered into the study received initial treatment which comprised four cycles of adriamycin and vincristine, prednisolone and L‐asparaginase with the first cycle (OPAL). In 1978, six cycles were given, with escalating doses of adriamycin and cyclophosphamide from cycle 3 (HEAV'D). Central nervous system (CNS) prophylaxis incorporated intrathecal methotrexate and cytosine arabinoside with cranial irradiation. Maintenance chemotherapy consisted of 6‐mercaptopurine, cyclophosphamide and methotrexate for 3 years.Results obtained with the OPAL and HEAV'D regimens were not significantly different. The overall complete remission (CR) rate was 66% (73/111), factors correlating unfavourably with achievement of CR being advanced age (PPPP<0.04). Twenty‐four patients remain alive, with a median survival of all patients of 18 months.