Results of the therapy of acute leukemia. A cooperative trial by the Italian Association Against Leukemias
Polli, E.E.
Israel Journal of Medical Sciences 14(12): 1203-1211
1978
ISSN/ISBN: 0021-2180 PMID: 285045 Document Number: 134767
Protocol 7401 [Regimen A.sbd.G-mercaptopurine, methotrexate, vincristine and prednisone and Regimen B.sbd.methotrexate, vincristine and prednisone] for the treatment of acute lymphoblastic leukemia was carried out by the study group of the Italian Association Against Leukemias. The 157 patients studied were divided into 2 groups.sbd.over and under 20 yr old. Patients reaching complete remission were then randomized into 1 of the 2 maintenance chemotherapy regimens (A or B). Complete remission was attained in 92.3% of 117 evaluated patients. Patients (95) aged under 20 years entered the maintenance regimen; 60% were in complete remission after 3 yr. Computer processing and multiple regression analysis have shown that age, lymph node involvement and the percentage of periodic acid-Schiff positive blast cells may have prognostic value. However, with the Logrank test it was possible to compare the 2 maintenance regimens in each group for each prognostic factor. Patients aged between 2-10 yr responded better to regimen A than to regimen B, as did patients with mild lymph node enlargement. Since some of the host-related factors studied emerged as significant for remission duration, 3 new protocols taking these prognostic factors into account were started. After 1 yr, actuarial curves showed that 91% of 80 patients in Protocol 7601 [vincristine, prednisone and L-asparaginase], 70% of 32 patients in Protocol 7602 [vincristine, adriamycin and prednisone] and 82% of 33 patients in Protocol 7603 [vincristine, daunorubicin and prednisone] were in complete remission.