Acute lymphoblastic leukemia in adults and children. Differences in response with similar therapeutic regimens.
Twenty-three adult patients (ages greater than 15 years) and 75 children with acute lymphoblastic leukemia were treated with similar intensive, sequential cytotoxic protocols (L-2). The adult patients have lower remission rate (78%) than the children (98%). The duration of remission and the length of survival are also shorter in adults. The incidence of central nervous system (CNS) relapse in adults (27.7%) is higher than in children (7.1%) suggesting that prolonged prophylactic intrathecal methotrexate as given to the children is more effective than the schedule used for adults where intrathecal methotrexate was given only in the first 2 months of therapy. The low incidence of CNS involvement in children on the L-2 protocol compares favorably with other series reported using a combination of cranial irradiation and intrathecal methotrexate. In both adults and children there seemed to be a higher incidence of CNS involvement in patients with initial white blood cell counts greater than 25,000 cells/mm3.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001215:Asparaginase / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000453:epidemiology; D002330:Carmustine / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000627:therapeutic use; D003630:Daunorubicin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D007278:Injections, Spinal; D007945:Leukemia, Lymphoid / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012075:Remission, Spontaneous; D013125:Spinal Neoplasms / Q000453:epidemiology; D013866:Thioguanine / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use
D003561:Cytarabine; D014750:Vincristine; D001215:Asparaginase; D013866:Thioguanine; D002330:Carmustine; D011241:Prednisone; D008727:Methotrexate; D003630:Daunorubicin