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

• 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
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19890415)63:8<1466::AID-CNCR2820630803>3.0.CO;2-I

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.