title: Short-term intensive treatment (V.A.A.P.) of adult acute lymphoblastic leukemia and lymphoblastic lymphoma.
abstract: Increased dosages of cytosine arabinoside (Ara-C) have been shown to be active in remission induction and consolidation treatment of patients with primary refractory acute lymphoblastic leukemia (ALL) and lymphoblastic non-Hodgkin's lymphoma (lyNHL). From August 1983 to December 1986 we treated 25 patients with ALL (9) and lyNHL, stage III and IV (16), median age 22 (range 15-48 yr) with a protocol consisting of remission induction with vincristine, prednisone, adriamycine and Ara-C (1 g/m2 twice daily as 2-h infusion d1-6) and intrathecal methotrexate, followed by consolidation courses with vincristine, prednisone, adriamycine and Ara-C (3 g/m2, twice daily as 2-h infusion d1-4) and intrathecal methotrexate. Some patients received CNS and/or mediastinal irradiation. No maintenance was given. 18 patients (72%) achieved complete remission (5 of the 11 previously treated and 13 of the 14 previously untreated patients). Consolidation courses were given to 17 patients. 5 of them relapsed in the bone marrow (3), skin (1) and CNS plus bone marrow (1) at 5, 5, 6, 6 and 24 months. The duration of complete remission ranged from 5 to 51+ months; the median could not yet be calculated. Short-term intensive treatment might be a worthwhile approach for ALL and lyNHL.
authors.affiliation: Dept. of Medicine, Leiden University Medical Center, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Willemze
authors.forename: W G
authors.initials: WG
authors.lastname: Peters
authors.forename: L P
authors.initials: LP
authors.lastname: Colly
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D008577:Meningeal Neoplasms / Q000517:prevention & control; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014750:Vincristine; D004317:Doxorubicin; D011241:Prednisone; D008727:Methotrexate