title: VM-26 and cytosine arabinoside combination chemotherapy for initial induction failures in childhood lymphocytic leukemia.
abstract: Combination chemotherapy with VM-26 and ara-C was given to 14 children with acute lymphocytic leukemia who had not responded to initial treatment with prednisone, vincristine, daunomycin, and asparaginase. Nine of these patients had also received ara-C. At diagnosis, five children were classified as having standard prognostic features and nine as being at high risk for treatment failure. The drug combination was administered by vein twice a week for four weeks at dosages of 165 mg/m2 for VM-26 and 300 mg/m2 for araC. Nine complete remissions, five in patients with high-risk leukemia, were induced with acceptable toxicity; all 9 subsequently were given continuation therapy with oral mercaptopurine and methotrexate. Four of the 9 patients have relapsed at 2--21 months. All treatment was stopped in 2 patients after 30 months of complete remission. Combinations of VM-26 and ara-C represent an alternative remission induction treatment for patients who fail to attain initial remission with agents of established effectiveness. These agents may especially benefit patients with prognostic features indicating a high risk of treatment failure.
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001855:Bone Marrow Diseases / Q000139:chemically induced; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000008:administration & dosage* / Q000009:adverse effects; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D007945:Leukemia, Lymphoid / Q000188:drug therapy*; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D011034:Podophyllotoxin / Q000031:analogs & derivatives*; D012075:Remission, Spontaneous; D013713:Teniposide / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents; D003561:Cytarabine; D013713:Teniposide; D015122:Mercaptopurine; D011034:Podophyllotoxin; D008727:Methotrexate