“Total therapy” of childhood acute lymphocytic leukemia View Full Text


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Article Info

DATE

1971-08

AUTHORS

Donald P Pinkel, Joseph V Simone, H Omar Hustu, Rhomes J

ABSTRACT

In 1962 studies were initiated to determine, first, whether a significant 5 year cure rate of childhood acute lymphocytic leukemia (ALL) was attainable with present therapeutic agents and secondly, how best this could be accomplished. The basic plan was (l) to induce complete remission promptly, (2) to administer multiple antileukemic drugs for 2–3 years with the purpose of eradicating all residual leukemia and (3) to prevent nervous system leukemia by “prophylactic” central nervous system (CNS) therapy early during remission. From early pilot studies with relatively few patients the program has evolved to more elaborate ivestigations involving large numbers of patients and comparisons of alternate treatment methods. Of 37 children who developed complete remission (CR) in studies I-III (1962–65) 7 survive in CR for 6 to 8 years and have been off all therapy for 3 to 5 years. Study IV (1965–67) demonstrated the superiority of full dosage over half dosage of combination chemotherapy. Of 31 patients entering CR in Study V (1967–68) 20 remain in continuous CR for 2½ to 3 years; therapy has been discontinued in the majority and will soon be terminated in the reaminder. In Study VI (1968–70) 94 children in CR were randomized for craniospinal radiation (2400 R) or none. Of 45 who received craniospinal radiation only 2 developed initial relapse in the CNS and 35 remain in continuous CR for 8 months to 2½ years. Of 49 who did not receive radiation, 25 have developed CNS relapse. It is concluded that a significant 5 year cure rate is an attainable goal in ALL, that ALL can no longer be considered an incurable disease, that CNS therapy inhibits CNS relapse, and that paliation is no longer an acceptable approach to the management of this disease. More... »

PAGES

pr1971264

Identifiers

URI

http://scigraph.springernature.com/pub.10.1203/00006450-197108000-00155

DOI

http://dx.doi.org/10.1203/00006450-197108000-00155

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1048425119


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