Intensive drug combination and Ommaya device for prophylactic chemotherapy in lymphoblastic leukemia

M. Haghbin, C. Tan, B. Clarkson

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6 Scopus citations

Abstract

Nineteen children and 14 adults >15 yr with acute lymphoblastic leukemia were treated with an intensive drug combination regimen consisting of 3 phases: induction, prednisone (Pred), vincristine (VCR) and adriamycin (ADR); consolidation, methotrexate (MTX), arabinosyl cytosine (Ara C), thioguanine, L asparaginase and cyclophosphamide (CP); and maintenance, VCR, Pred, ADR, MTX, mercaptopurine, dactinomycin, CP and 1,3 bis (2 chloroethyl) 1 nitrosourea. In patients with an initial WBC ≥ 25,000/cu mm, an Ommaya device was placed after attainment of remission for intraventricular injections of MTX and Ara C. Intraspinal injections of these drugs were given to those with lower WBCs. The age range was from 2 mth to 72 yr. All but 1 adult entered remission. An Ommaya device was put in 5 children and 3 adults with initial WBCs ranging from 32,600 to 1 million/cu mm. The duration of remissions was 1-16 mth in children and 2-18 mth in adults. All children remained in complete remission, but 4 adults had hematological relapse within 3-9 mth. It is expected that a more vigorous consolidation regimen, and intraventricular chemotherapy in patients with initial high WBC who are at a greater risk for meningeal leukemia, will produce better results than the earlier protocol.

Original languageEnglish
Pages (from-to)No. 658
JournalProceedings of the American Association for Cancer Research
Volume16
Issue number66
StatePublished - 1975
Externally publishedYes

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