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Four‐agent induction/consolidation therapy for childhood acute lymphoblastic leukemia: An Indian experience
Author(s) -
Advani S. H.,
Lyer R. S.,
Pai S. K.,
Gopal R.,
Saikia T. K.,
Nair C. N.,
Kurkure P. A.,
Nadkarni K. S.,
Pai V. R.
Publication year - 1992
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830390403
Subject(s) - medicine , vincristine , prednisolone , regimen , aplasia , induction chemotherapy , gastroenterology , population , levamisole , surgery , chemotherapy , cyclophosphamide , environmental health
During 1984‐1986, a total of 128 children with acute lymphoblastic leukemia (ALL) were treated with an induction‐consolidation regimen consisting of doxorubicin, vincristine, cytosine‐arabinoside, and prednisolone. One hundred two (80%) patients belonged to high‐risk group. The complete remission rate for all the patients was 91%. The event‐free survival at 5 years was 32.0% ± 23%. On multivariate analysis the event‐free survival and disease‐free survival was not altered by age, sex, WBC count, platelet count, LDH level, and surface phenotype. Infection due to prolonged marrow aplasia was a common complication, leading to mortality of 8 patients during induction and 33 patients during first remission. The relapse rate has been 36% (42 patients). The predominance of high‐risk ALL in the Indian population underscores the need for intensive therapy. Improved supportive care during induction and remission seems essential to decrease therapy‐related mortality, leading to improved survival.