Long-term survival in acute lymphoblastic leukaemia in adults: a prospective study of 51 patients. Finnish Leukaemia Group.
Between November 1983 and January 1987, 51 consecutive previously untreated adults below 65 years of age were treated for acute lymphoblastic leukaemia with L1 or L2 morphology. Induction regimen for the first 15 patients consisted of 4 weekly doses of doxorubicin and vincristine, and of asparaginase and prednisolone. Two more doses of doxorubicin and vincristine were given for refractory disease. Next 36 patients received in addition cyclophosphamide on day 1. Consolidation comprised 17 rotating cycles of three regimens. Three intensification cycles were given, and maintenance treatment lasted until 3 years, or relapse. Median follow-up time for living patients is 62 months. 82% of the patients achieved remission. Median relapse-free survival (RFS) was 13 months, and 17% of the patients are in remission at 54+ to 80+ months. Age over 25 yr, a low white blood cell (WBC) count, and a low blast cell count were associated with a longer RFS. Median survival was 24 months, and 33% of the patients lived for 4 yr. Adverse prognostic factors were: age less than or equal to 25 of greater than 45 yr, a high WBC count, and a high blast cell count. The results support the policy of concentrating more effort on the initial chemotherapy.
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D012074:Remission Induction; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D004317:Doxorubicin; D011239:Prednisolone; D001215:Asparaginase