Treatment intensity and outcome for children with acute lymphocytic leukemia of standard risk. A pediatric oncology group study

Four hundred thirty‐four children, with good‐risk acute lymphocytic leukemia (ALL), were assigned randomly to receive intensive or less intensive maintenance therapy with 6‐mercaptopurine and methotrexate, plus vincristine and prednisone pulses in such a way that patients on treatment 1 had their le...

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Bibliographic Details
Published in:Cancer 1989-04, Vol.63 (8), p.1466-1471
Main Authors: van Eys, Jan, Berry, Daisilee, Crist, William, Doering, Ed, Fernbach, Donald, Pullen, Jeanette, Shuster, Jon
Format: Article
Language:English
Subjects:
Antineoplastic agents
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Chemotherapy
Child
Child, Preschool
Combined Modality Therapy
Drug Administration Schedule
Female
Humans
Infant
Infection - epidemiology
Male
Medical sciences
Pharmacology. Drug treatments
Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Prognosis
Remission Induction
Risk
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Summary:Four hundred thirty‐four children, with good‐risk acute lymphocytic leukemia (ALL), were assigned randomly to receive intensive or less intensive maintenance therapy with 6‐mercaptopurine and methotrexate, plus vincristine and prednisone pulses in such a way that patients on treatment 1 had their leukocyte counts maintained between 1500 and 3000/mm3. Patients on treatment 2 had leukocyte counts maintained between 3000 and 4500/mm3. Absolute granulocyte counts were maintained above 500/mm3 on both groups. All children received induction treatment with vincristine, prednisone and L‐asparaginase and had central nervous system (CNS) prophylaxis with cranial irradiation and intrathecal methotrexate. The overall remission rate was 94%. Event‐free survival at 8 years was 44% (SE, 5.6%). There was no significant difference in outcome between treatments 1 and 2 (P = 0.83). The incidence of infection was similar overall and not significantly different between treatment arms.
ISSN:0008-543X
1097-0142
DOI:10.1002/1097-0142(19890415)63:8<1466::AID-CNCR2820630803>3.0.CO;2-I