Abstract
We initiated a protocol for non-T-cell childhood ALL that used q 3 weekly ADR. A random half of patients (pts) also received high dose ASP q 1 week for 6 months. All patients received cranial radiation and intrathecal methotrexate (MTX). After completing ADR, q 3 weekly pulses of MTX and 6-mercaptopurine were begun. Therapy was electively discontinued after the completion of 30 months. Seventy-four pts entered remission between 1977 and 1979. After randomization there were two 36-pt groups: A) ADR without ASP; B) ADR with ASP. The groups were comparable in age and white blood count. However, Grp A had 11/13 patients whose lymphoblasts lacked the common ALL antigen. In Grp A 16/36 pts had failed compared to Grp B 9/36. The median time to failure for Grp A was 28 months and disease-free survival in Grp B is 62%. The difference between the groups is not statistically significant, but the trend is apparent. Of the failures in Grp A, 15/16 relapsed; 11 in the bone marrow (BM) only, 1 in the central nervous system (CNS) and 3 in the BM/CNS. Of the 9 Grp B failures, 6 were relapses (3 BM, 1 testicle, 2 CNS). Four children died in remission: 3 of adriamycin cardiomyopathy and 1 of sepsis. Efforts to decrease toxicity involve prediction of cardiac toxicity by the measurement of the myocardial contractile state (methoxamine stress testing) and pharmacologic studies of ADR/ASP interactions. Further trials of therapy using high dose ASP for prolonged periods of treatment in childhood ALL appear warrented.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sallan, S. 867 THERAPY OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA (ALL) USING ADRIAMYCIN (ADR) WITH OR WITHOUT HIGH DOSE ASPARAGINASE (ASP). Pediatr Res 15 (Suppl 4), 587 (1981). https://doi.org/10.1203/00006450-198104001-00892
Issue Date:
DOI: https://doi.org/10.1203/00006450-198104001-00892