title: Impact of reinduction regimens for relapsed and refractory acute lymphoblastic leukemia in adults.
abstract: The clinical outlook for adults with acute lymphoblastic leukemia (ALL) has improved with the use of intensive chemotherapy. Complete remissions (CR) are achieved in 80% of adults but the majority relapse on maintenance chemotherapy and a few exhibit primary resistance to induction therapy. This report compares the various salvage treatments and provides guidance in selecting a regimen with the optimum clinical outcome. Regimens using high-dose ara-C (HDAC) in combination with mitoxantrone, amsacrine, or idarubicin are superior to HDAC alone or with L-asparaginase. The sequential administration of methotrexate and L-asparaginase is equally effective. The duration of second CR is short for all chemotherapeutic regimens.
authors.affiliation: Department of Internal Medicine, University of California, Davis 95816.
authors.forename: J L
authors.initials: JL
authors.lastname: Welborn
mesh_terms: D000328:Adult; D000677:Amsacrine / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001217:Aspartate-Ammonia Ligase / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D003561:Cytarabine / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015994:Incidence; D008727:Methotrexate / Q000008:administration & dosage; D008942:Mitoxantrone / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012008:Recurrence; D016879:Salvage Therapy
chemical_list: D000677:Amsacrine; D003561:Cytarabine; D008942:Mitoxantrone; D001217:Aspartate-Ammonia Ligase; D008727:Methotrexate; D015255:Idarubicin