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Analysis of the results of United Kingdom Acute Lymphoblastic Leukaemia (UKALL) trials since 1972 showed that no improvement in remission or survival had been achieved over the 7 years up to 1979 for 1470 patients in trials UKALL II to VI. UKALL VII (1979-80) gave somewhat better results for a small group of good-prognosis patients. However, UKALL VIII, introduced in 1980, produced a 15-20% increase in 4-year disease-free survival compared with the best results of previous studies, despite a higher frequency of treatmentinduced morbidity and mortality. Factors possibly contributing to this highly significant difference include the policy of continuing therapy without interruption during induction, a long course of intramuscular asparaginase over 3 weeks, full-dose mercaptopurine and co-trimoxazole during central-nervous-system prophylaxis, and the use of sustained maximum tolerated oral doses of mercaptopurine and methotrexate maintenance. An intensive sustained approach

Improvement in treatment for children with acute lymphoblastic leukaemia