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Intensive induction/consolidation therapy without maintenance in adult acute lymphoblastic leukaemia: a pilot assessment
Author(s) -
Wernli M.,
Tichelli A.,
Fliedner V. von,
Re G. Brun del,
Chaputs B.,
Fey M. F.,
Fopp M.,
Gmür J.,
Grob JP.,
Jacky E.,
Pedrazzini A.,
Schmid L.,
Senn HJ.,
Tobler A.,
Gratwohl A.
Publication year - 1994
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1994.tb04867.x
Subject(s) - medicine , maintenance therapy , chemotherapy , induction chemotherapy , confidence interval , randomized controlled trial , surgery , pediatrics
Summary . Maintenance chemotherapy for up to 3 years is traditionally given to patients with acute lymphoblastic leukaemia (ALL) achieving complete remission. We questioned the value of such maintenance therapy in adult patients treated with intensive induction/consolidation. In a phase II study (SAKK 33/86) 63 patients between 17 and 72 years of age (median 27 years) with newly diagnosed ALL were treated with three intensive cycles of marrow‐ablative chemotherapy. All subtypes were included. No maintenance phase was added. 53 patients (84%) entered a complete remission (CR) and 21 (33%) continue to be in unmaintained remission for 11‐69 months (median 21 months). The disease‐free survival of patients achieving CR and completing all three cycles is 40% at 3 years, with a 95% confidence interval of ± 19%. These findings are comparable to the results of conventional studies. We conclude that maintenance therapy might not be needed in all adult ALL patients. Its value should be tested in a randomized trial. For patients failing, novel approaches are needed to improve outcome in adult ALL.