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Sequentisl induction chemotherapy with vincristine, daunorubicin cyclophosphamide, and prednisone in adult acute lymphoblastic leukemia

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Abstract

Sequential chemotherapy with vincristine, daunorubicin, cyclophosphamide, and prednisone doses was administered to 57 adult patients with acute lymphoblastic leukemia (ALL). Complete remission (CR) was achieved in 51 (89%, 95% confidence intervals, [CI] 78–96%). Among patients achieving CR, 62% were in CR after one sequence of chemotherapy, 23% after two sequences, and 5% after three sequences. Six patients (11%) had resistant disease. All patients experienced profound myelosuppression. Median time to recovery of neutrophils > 0.5 × 109/l was 22 days (range: 5–89 days), and of platelets >100×l09/l 21 days (range: 0–45 days). Nonhematologic WHO grade 3 or more side effects consisted predominantly of hyperbilirubinemia (7%), mucositis (5%), nausea and vomiting (2%), and cutaneous toxicity (1%). Severe infectious complications occurred in only 14% of cases. One patient (2%, 95% CI 0–9%) died of therapy-related toxicity while in early CR. We concluded that sequential use of prednisone seemed at least as effective as continuous administration at the expense of a few adverse side effects.

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Authors and Affiliations

  1. Department of Hematology, Hôpital Edouard Herriot, F-69437, Lyon Cedex 03, France

    X. Thomas, C. Danaila, Q. K. Bach, C. Sebban, E. Archimbaud & D. Fiere

  2. Department of Hematology, Hôpital de Hautepierre, Strasbourg, France

    P. Dufour

  3. Department of Medicine, Hôpital N. D. de Bon Secours, Metz, France

    B. Christian

  4. Department of Hematology, Centre Hospitalier, Annecy, France

    B. Corront

  5. Department of Hematology, University Clinics of Mont-Godinne, Yvoir, Belgium

    A. Bosly

  6. Department of Hematology, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France

    Y. Bastion

  7. Department of Internal Medicine I, Hematology Clinic, Hôpital Cimiez, Nice, France

    N. Gratecos

  8. Department of Medicine G, Hopital Sud, Rennes, France

    R. Leblay

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  1. X. Thomas
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  2. C. Danaila
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  3. Q. K. Bach
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  4. C. Sebban
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  5. E. Archimbaud
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  6. D. Fiere
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  8. B. Christian
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  9. B. Corront
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  13. R. Leblay
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Thomas, X., Danaila, C., Bach, Q.K. et al. Sequentisl induction chemotherapy with vincristine, daunorubicin cyclophosphamide, and prednisone in adult acute lymphoblastic leukemia. Ann Hematol 70, 65–69 (1995). https://doi.org/10.1007/BF01834381

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  • DOI: https://doi.org/10.1007/BF01834381

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