Combination chemotherapy and radiotherapy for acute lymphocytic leukemia in adults: Results of CALGB protocol 7113

Henderson, Edward S.; Scharlau, Carol; Cooper, M. Robert; Haurani, Farid I.; Silver, Richard T.; Brunner, K. W.; Carey, Robert W.; Falkson, Geoffrey; Blom, Johannes; Nawabi, Ismat; Levine, Arthur S.; Bank, Arthur; Cuttner, Janet; Cornwell, Gibbons G.; Henry, Patrick H.; Nissen, Nis I.; Wiernik, Peter H.; Leone, Louis A.; Wohl, Herbert; Rai, Kanti; James, G. Watson; Weinberg, Vivian; Glidewell, Oliver; Holland, James F.

doi:10.1016/0145-2126(79)90036-5

Cited by 51 publications

(3 citation statements)

References 13 publications

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“…In the randomized trial reported by Gotlieb et a1 [46], and in the report by Amadori et a1 [43], the duration of CR was not different between those who achieved a CR with VCR + PRED alone and in those who achieved a CR with VCR + PRED + anthracycline and/or asparaginase. In three recent reports, however, which used induction, consolidation, and maintenance regimens of variable intensity, the median survival and duration of CR have been longer [5,44,57]. In the study by Gee et a1 [5], who used a very intensive induction, consolidation, and maintenance regimen (L2 protocol), the median duration of CR was 25 months and the median survival was 33 months.…”

Section: Discussionmentioning

confidence: 99%

Results of induction therapy with vincristine and prednisone alone in adult acute lymphoblastic leukemia: Report of 43 patients and review of the literature

Hess

Zirkle

1982

American J Hematol

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The complete remission (CR) rate in children with acute lymphoblastic leukemia (ALL) who received vincristine (VCR) plus prednisone (PRED) alone for induction is > 90%, and has not improved with the use of more intensive regimens. In adults with ALL, using the same regimen, a CR rate of only 50% is frequently quoted, and is apparently based mainly on unpublished data on only 13 patients from an early Acute Leukemia Group B protocol. We reviewed the case records of 43 adults with previously untreated ALL seen between July I , 1966 and December 3 I , 1978 who received VCR + PRED alone for induction. A CR rate of 66% was achieved and compares to an overall figure of 61% from 162 patients collected from the literature. The CR rate was age dependent with 21/29 (76%) < 50 years of age achieving a CR compared to 4/19 (29%) who were 2 50 years of age (P < 0.02). The median duration of CR was 8.3 months. For those who achieved a CR, the median survival was 19 months compared to five months for those who either failed to achieve a CR or who achieved only a partial remission (P = 0.004). All patients who achieved a CR received maintenance therapy, and approximately one-half also received CNS prophylaxis with intrathecal methotrexate. The incidence of isolated CNS relapse was 1 1 % in those who received CNS prophylaxis compared to 20% in those who did not.From these data and a review of the literature, we conclude that approximately twothirds of adults with ALL will achieve a CR with the use of VCR + PRED alone. The median duration of CR, however, is < one ycar and the median survival is approximately two years. Whether the use of more intensive induction, consolidation, and maintenance regimens will improve these results remains to be established.

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Section: Discussionmentioning

confidence: 99%

Results of induction therapy with vincristine and prednisone alone in adult acute lymphoblastic leukemia: Report of 43 patients and review of the literature

Hess

Zirkle

1982

American J Hematol

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“…In adults the 5-year survival is <30% in most series (Lister et al, 1978;Jacobs & Gale, 1984;Henderson et al, 1979 (Bennett et al, 1981). Cytochemical stains for Sudan black, myeloperoxidase, PAS and acid phosphatase were also carried out.…”

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confidence: 99%

Adult acute lymphoblastic leukaemia: A study of prognostic features and response to treatment over a ten year period

Marcus¹,

Catovsky²,

Johnson³

et al. 1986

Br J Cancer

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Summary Between 1974 and 69 adults with acute lymphoblastic leukaemia (ALL) were treated with two different protocols. Fifty-four (78%) of the patients entered complete remission (CR); 27 of these then received a consolidation protocol consisting of daunorubicin, cytosine arabinoside and 6-thioguanine, followed by two courses of intravenous methotrexate 500 mg m2 with folinic acid rescue. All patients received intrathecal methotrexate and cranial irradiation (24 Gy) followed by maintenance therapy with 6-mercaptopurine and methotrexate for at least 2 years. The median survival for all patients was 23 months from the time of presentation with an actuarial 5-year survival of 21%. The actuarial chance of surviving 5 years in CR for patients receiving the consolidation protocol was 38% compared to 19% for patients receiving no consolidation (P=NS). Only patient age and white cell count at presentation were found to influence the chance of achieving CR and the chance of overall survival. The presence or absence of c-ALL antigen did not influence prognosis. Patients younger than 35 years with low white cell counts at presentation (< O x 109 1 -1) had a particularly good prognosis but no patient with T-ALL and no patient older than 50 years old at diagnosis survived more than 18 months.

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“…Studies were grouped into 11 categories by randomized comparison. Table I gives details of the CNS‐directed treatments 11–56. Steroid use is given in supplementary Table S1.…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta‐analysis of randomized trials of central nervous system directed therapy for childhood acute lymphoblastic leukemia

Richards

Pui

Gayon

2012

Pediatric Blood & Cancer

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Treatment of the central nervous system (CNS) is an essential therapy component for childhood acute lymphoblastic leukaemia (ALL). Individual patient data from 47 trials addressing 16 CNS treatment comparisons were analyzed. Event-free survival (EFS) was similar for radiotherapy versus IT, and radiotherapy plus IT versus IVMTX plus IT. Triple intrathecal therapy (TIT) gave similar EFS but poorer survival than ITMTX, but additional IVMTX improved both outcomes. One trial resulted in similar EFS and survival with IVMTX plus ITMTX versus TIT alone. Radiotherapy can generally be replaced by IT therapy. TIT should be used with effective systemic therapy such as IVMTX.

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Combination chemotherapy and radiotherapy for acute lymphocytic leukemia in adults: Results of CALGB protocol 7113

Cited by 51 publications

References 13 publications

Results of induction therapy with vincristine and prednisone alone in adult acute lymphoblastic leukemia: Report of 43 patients and review of the literature

Results of induction therapy with vincristine and prednisone alone in adult acute lymphoblastic leukemia: Report of 43 patients and review of the literature

Adult acute lymphoblastic leukaemia: A study of prognostic features and response to treatment over a ten year period

Systematic review and meta‐analysis of randomized trials of central nervous system directed therapy for childhood acute lymphoblastic leukemia

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