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Cytokinetically based induction chemotherapy and splenectomy for childhood acute nonlymphocytic leukemia.

Publication ,  Journal Article
Dahl, GV; Kalwinsky, DK; Murphy, S; Look, AT; Amadori, S; Kumar, M; Novak, R; George, SL; Mason, C; Mauer, AM; Simone, JV
Published in: Blood
October 1982

A four-drug regimen, based on cell kinetic principles, induced complete remissions in 68 of 95 children (72%) with acute nonlymphocytic leukemia (ANLL). Patients entered remission after 2-5 weekly cycles of vincristine-daunorubicin (day 1) followed by sequential cytosine arabinoside and 6-azauridine (days 4-7). With continuation therapy of monthly vincristine-doxorubicin-cyclophosphamide, weekly cytosine arabinoside, and daily 6-mercaptopurine, the median duration of complete remission was 10 mo and the median survival time 21 mo. Portal triaditis, evident in 11 of 23 patients with liver biopsies, was associated with long remissions. A larger spleen size (greater than 5 cm) and a higher myeloblast labeling index (greater than 10%) at diagnosis were clearly related to shorter durations of remission. Splenectomy within 1 mo of remission had no statistically significant effect on the frequency of relapse or length of remission. Patients without central nervous system (CNS) leukemia at diagnosis, all treated prophylactically with intrathecal methotrexate, had a low frequency of initial CNS relapse (3/56, 5%). The 2-yr disease-free survival rate is 29% (20 of 68 patients attaining complete remission). fifteen patients have completed 2.5 yr of therapy, and each remains in continuous complete remission, off treatment, for 1+ -36+ mo. This induction chemotherapy was as effective as more intensive regimens, with the advantage of less toxicity and shorter periods of hospitalization.

Duke Scholars

Published In

Blood

ISSN

0006-4971

Publication Date

October 1982

Volume

60

Issue

4

Start / End Page

856 / 863

Location

United States

Related Subject Headings

  • Vincristine
  • Splenectomy
  • Prednisone
  • Methotrexate
  • Mercaptopurine
  • Leukemia
  • Injections, Spinal
  • Immunology
  • Humans
  • Doxorubicin
 

Citation

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Dahl, G. V., Kalwinsky, D. K., Murphy, S., Look, A. T., Amadori, S., Kumar, M., … Simone, J. V. (1982). Cytokinetically based induction chemotherapy and splenectomy for childhood acute nonlymphocytic leukemia. Blood, 60(4), 856–863.
Dahl, G. V., D. K. Kalwinsky, S. Murphy, A. T. Look, S. Amadori, M. Kumar, R. Novak, et al. “Cytokinetically based induction chemotherapy and splenectomy for childhood acute nonlymphocytic leukemia.Blood 60, no. 4 (October 1982): 856–63.
Dahl GV, Kalwinsky DK, Murphy S, Look AT, Amadori S, Kumar M, et al. Cytokinetically based induction chemotherapy and splenectomy for childhood acute nonlymphocytic leukemia. Blood. 1982 Oct;60(4):856–63.
Dahl, G. V., et al. “Cytokinetically based induction chemotherapy and splenectomy for childhood acute nonlymphocytic leukemia.Blood, vol. 60, no. 4, Oct. 1982, pp. 856–63.
Dahl GV, Kalwinsky DK, Murphy S, Look AT, Amadori S, Kumar M, Novak R, George SL, Mason C, Mauer AM, Simone JV. Cytokinetically based induction chemotherapy and splenectomy for childhood acute nonlymphocytic leukemia. Blood. 1982 Oct;60(4):856–863.

Published In

Blood

ISSN

0006-4971

Publication Date

October 1982

Volume

60

Issue

4

Start / End Page

856 / 863

Location

United States

Related Subject Headings

  • Vincristine
  • Splenectomy
  • Prednisone
  • Methotrexate
  • Mercaptopurine
  • Leukemia
  • Injections, Spinal
  • Immunology
  • Humans
  • Doxorubicin