Cessation of Therapy during Complete Remission of Childhood Acute Lymphocytic Leukemia

Abstract

Abstract To assess the need for prolonged therapy in acute lymphocytic leukemia in remission, we studied the course of 132 patients removed from therapy after two to three years of remission. The median period off therapy was 21 months, with a range of one month to 7.5 years. Of the patients removed from therapy, 21 have relapsed (16 per cent). Of the patients who relapsed, six had not received specific Central-nervous-system therapy. We conclude that (1) programs for treatment of childhood acute lymphocytic leukemia have resulted in an impressive number of long-term leukemia-free survivals even after cessation of all therapy, (2) the likelihood of relapse after therapy is stopped is greatest in the first year, (3) relapse was more frequent in patients who had not received Central-nervous-system irradiation, and (4) no other feature was found to predict whether relapse would occur after stopping therapy. (N Engl J Med 291:1230–1234, 1974)