title: Four-agent induction/consolidation therapy for childhood acute lymphoblastic leukemia: an Indian experience.
abstract: During 1984-1986, a total of 128 children with acute lymphoblastic leukemia (ALL) were treated with an induction-consolidation regimen consisting of doxorubicin, vincristine, cytosine-arabinoside, and prednisolone. One hundred two (80%) patients belonged to high-risk group. The complete remission rate for all the patients was 91%. The event-free survival at 5 years was 32.0% +/- 23%. On multivariate analysis the event-free survival and disease-free survival was not altered by age, sex, WBC count, platelet count, LDH level, and surface phenotype. Infection due to prolonged marrow aplasia was a common complication, leading to mortality of 8 patients during induction and 33 patients during first remission. The relapse rate has been 36% (42 patients). The predominance of high-risk ALL in the Indian population underscores the need for intensive therapy. Improved supportive care during induction and remission seems essential to decrease therapy-related mortality, leading to improved survival.
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Parel, Bombay, India.
authors.forename: S H
authors.initials: SH
authors.lastname: Advani
authors.forename: R S
authors.initials: RS
authors.lastname: Iyer
authors.forename: S K
authors.initials: SK
authors.lastname: Pai
authors.forename: R
authors.initials: R
authors.lastname: Gopal
authors.forename: T K
authors.initials: TK
authors.lastname: Saikia
authors.forename: C N
authors.initials: CN
authors.lastname: Nair
authors.forename: P A
authors.initials: PA
authors.lastname: Kurkure
authors.forename: K S
authors.initials: KS
authors.lastname: Nadkarni
authors.forename: V R
authors.initials: VR
authors.lastname: Pai
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D003561:Cytarabine; D014750:Vincristine; D004317:Doxorubicin; D011239:Prednisolone