Induction and maintenance of remission in acute leukemia

Abstract

A total of 227 patients—124 with acute lymphoblastic leukemia (ALL) and 103 with acute myeloblastic leukemia (AML)—have been studied in order to evaluate the therapeutic effectiveness of vincristine, daunorubicin, and prednisone for induction followed by consolidation courses every 6 months with these drugs and either 6-mercaptopurine and methotrexate (plan A) or methotrexate alone (plan B) for maintenance of remission. In ALL, complete remission (CR) was achieved in 90.2% of untreated and 71.6% of previously treated patients. In AML, 34.8% untreated and 23.5% previously treated patients obtained CR. There was no statistically significant difference between the two maintenance regimens. Median duration of hematologic remission in ALL was 16 months and that of complete remission terminating in either meningeal, visceral, or bone marrow relapse was 9 months. Median survival was 18.2 months. In AML, the median survival was 11.8% months for those that achieved CR, 4.2 months for the partial remission (PR) group, and 0.9 months for nonresponders.