Results of a multicentre study of the treatment of acute lymphoblastic leukaemia in adolescents and adults (1978-1981)
Willemze, R.; Haanen, C.; Dekker, A.; Sizoo, W.; Abels, J.; Tricot, G.; Kerkhofs, H.; Von Dem Borne, A.; Kurstjens, R.; Roozendaal, K.J.; Goudsmit, R.
Netherlands Journal of Medicine 25(9): 303-307
1982
ISSN/ISBN: 0300-2977 PMID: 6757770 Document Number: 185540
Adolescents and adult patients with acute lymphoblastic leukemia (ALL) were treted by a standardized protocol. Complete remission was attained in 62 (of 81) patients (76%) with vincristine, prednisone, daunorubicin (in 7 cases with additional cytosine arabinoside). CNS involvement was prevented by periodic intrathecal MTX count in excess of 20 .times. 109/l, and 20 mo. for those with a lower WBC count. The presence of initial CNS involvement and T-cell markers was not of major prognostic significance. Chromosomal abnormalities at the time of diagnosis were found in 63% of the patients tested. Relapses were confined to bone marrow (BM; 14), CNS (5), BM + CNS (1), BM + testis (2), BM + lymph nodes (1) and the eye (1). Second remissions were attained in 50% of these patients. The median survival of all remission patients was .apprx. 22 mo. The high frequency of early medullary and extramedullary relapses has so far hampered substantial progress in the management of adult ALL.