Intensive postremission chemotherapy without maintenance therapy in adults with acute lymphoblastic leukemia. Dutch Hemato-Oncology Research Group
| Autor: | A. W. Dekker, G Ossenkoppele, Peter C. Huijgens, J van der Lelie, Leo F. Verdonck, Roelof Willemze, M. B. Van't Veer, Pieter Sonneveld, H. C. Schouten, Bob Löwenberg, W. L. J. Van Putten, W. Sizoo, H. L. Haak |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Amsacrine Male Antimetabolites Antineoplastic Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Disease-Free Survival Drug Administration Schedule Maintenance therapy Internal medicine Acute lymphocytic leukemia Antineoplastic Combined Chemotherapy Protocols medicine Humans Etoposide Netherlands Chemotherapy Mitoxantrone Performance status business.industry Remission Induction Cytarabine Consolidation Chemotherapy Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Antineoplastic Agents Phytogenic Surgery Treatment Outcome Oncology Adult Acute Lymphoblastic Leukemia Female business medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 15:476-482 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | PURPOSE To investigate the value of intensive consolidation chemotherapy not followed by maintenance therapy in adult acute lymphoblastic leukemia (ALL). MATERIALS AND METHODS A multicenter phase II trial was conducted in 130 adult patients with ALL between 16 and 60 years of age. After standard induction therapy, postinduction chemotherapy was given: three courses of high-dose cytarabine (2,000 mg/m2 every 12 hours for four doses) in combination with amsacrine (course one), mitoxantrone (course two), and etoposide (course three). CNS prophylaxis consisted of 10 injections of intrathecal methotrexate (IT MTX). Patients younger than 50 years with an HLA-identical sibling were eligible to receive allogeneic bone marrow transplantation (BMT). RESULTS Ninety-five patients (73%) achieved complete remission (CR); 82% were younger than 50 years and 41% were older than 50 years. Seventeen patients (13%) were resistant to chemotherapy, and 18 (14%) died during induction treatment. Only age and performance status were significantly associated with response (PCONCLUSION Intensive consolidation including high-dose cytarabine not followed by maintenance therapy provides an outcome for adult patients with ALL that may be worse or even inferior compared with studies using long-term maintenance therapy. High-dose cytarabine in combination with IT MTX was effective for CNS prophylaxis. |
| Databáze: | OpenAIRE |
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