Early Application of Anthracyclines in Adult Acute Lymphoblastic Leukemia (ALL)

  • R. Bassan
  • A. Z. S. Rohatiner
  • T. Lerede
  • M. Carter
  • E. Di Bona
  • E. Pogliani
  • G. Rossi
  • P. Fabris
  • S. Morandi
  • G. Lambertenghi-Deliliers
  • P. Casula
  • M. Vespignani
  • T. A. Lister
  • T. Barbui
Conference paper
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 40)

Abstract

The anthracyclines (ANT) constitute a class of powerful antileukemic agents that exert their antiproliferative effects mainly through inhibition of nuclear topoisomerase II and the related induction of cellular apoptosis [1, 2]. The addition of ANT to prednisone (P), vincristine (V), and L-asparaginase (As) has significantly improved the outcome of patients with acute lymphoblastic leukemia (ALL) [3]. However, several questions remain. With regard to remission induction: which is the best drug (daunorubicin/DNR vs adriamycin/ADR vs idarubicin/IDR), schedule (weekly vs 3 consecutive days or other intensive schedule), and dose? With regard to the early postremission therapy: what is the best ANT containing regimen? Which subgroups of ALL are more sensitive to such therapy? How does resistance to ANT develop? And is it reversible? The results of ANT containing therapy were reviewed in a series of 328 adults with ALL who received either IDR or ADR as induction phase ANT in addition to V/P/As [4]. Once complete remission had been achieved, these patients received postremission therapy with multidrug regimens which contained ANT at high or low dose intensity (DI). High ANT DI was defined as delivery of a total ADR dose of 360-405 mg/m2 during remission induction and the early consolidation cycles (72-100 mg/m2/ cycle) or, a total IDR dose of 116-132 mg/m2 (24 mg/m2/cycle). Low ANT DI was defined as a total ADR dose of 120 mg/m2 (30 mg/m2/ cycle) or a total IDR dose of 58-80 mg/m2 (10-12 mg/m2/cycle).The results from these first studies are summarized as follows.

Keywords

Complete Remission Acute Lymphoblastic Leukemia Acute Myelogenous Leukemia Complete Remission Rate Leuk Lymphoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • R. Bassan
    • 1
  • A. Z. S. Rohatiner
    • 1
  • T. Lerede
    • 1
  • M. Carter
    • 1
  • E. Di Bona
    • 1
  • E. Pogliani
    • 1
  • G. Rossi
    • 1
  • P. Fabris
    • 1
  • S. Morandi
    • 1
  • G. Lambertenghi-Deliliers
    • 1
  • P. Casula
    • 1
  • M. Vespignani
    • 1
  • T. A. Lister
    • 1
  • T. Barbui
    • 1
  1. 1.Hematology Dpts. at Bergamo, Vicenza, Monza, Bolzano, Brescia, Cremona, Milan, Cagliari, and Venice HospitalsItaly, and ICRF Medical Oncology Unit at St. Bartholomew’s HospitalLondonUK

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