Results of the vincristine, doxorubicin, and dexamethasone regimen in adults with standard- and high-risk acute lymphocytic leukemia.

摘要: One hundred five untreated adult patients with acute lymphocytic leukemia (ALL) were entered on the vincristine, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), and Decadron (dexamethasone; Merck Sharp Dohme, West Point, PA) (VAD) regimen. Induction therapy VAD plus cyclophosphamide (CVAD) was followed by a 2-year rotating maintenance program multiple antileukemic combinations, included early intensifications high-dose cytarabine (ara-C) late intensification cyclophosphamide, carmustine (BCNU), etoposide (VP-16) (CBV) autologous bone marrow transplantation (BMT). Duration of 24 to 30 months. Eight-eight (84%) achieved complete remission (CR) VAD-CVAD, 94 (90%) ultimately had CR continuation as planned. mortality 3%; only half required prolonged hospitalization 1 week or longer, intravenous antibiotics. Maintenance given 79 patients, while nine histocompatibility locus antigen (HLA)-matched related donors underwent allogeneic BMT. The median duration 22 months, survival 19 Factors associated significantly worse rates older age, presence hypoalbuminemia hyperbilirubinemia, L2 L3 morphology, myeloid markers leukemic cells. Those durations elevated leukocyte absolute peripheral blast counts, Philadelphia chromosome (Ph)-positive B-cell ALL, more than one course achieve CR. Patients could be divided into standard-risk ALL (28% patients) high-risk (72% long-term 70% versus less 30%. 26 who CBV BMT similar outcome compared 21 did not (older medical contraindications, socioeconomic problems). absence cells affect prognosis. We conclude that is well-tolerated effective induction High-risk require alternative investigational approaches.