Treatment of Acute Nonlymphoblastic Leukemia in the Children’s Cancer and Leukemia Study Group
A total of 114 evaluable children with acute nonlymphoblastic leukemia (FAB categories: Ml, M2, M4, M5) entered into this study for 8 years. Of the 114 patients, 82 (71.9%) achieved complete remission (CR). There was no difference in the CR rate among five different protocols proposed by CCLSG. The rates of continuous complete remission (COR.) at 20 months were 43.0 ± 10.7% (mean ± SE), 23.4 ± 11.0%, and 65.8 ± 10.6% in Regimen I, Regimen II, and ANLL-861, respectively. The curves of CCR showed a plateau after 20 months, so that few cases of long-term remitters might relapse after 2 years. The primary CNS involvement did not affect the CCR duration. Sixteen patients have completed the chemotherapy, and 15 of them have remained in remission for 33–104 months after diagnosis. The incidence of CNS involvement was 9.6% (11/114). CNS involvement frequently occurred in patients with M4 and M5. The CCR duration in patients with monocytic leukemia (M5) was significantly shorter (p <0.01) than in patients with Ml or M2. Further strategy for the patients, including bone marrow transplantation, should be changed according to the ANLL subtype.
KeywordsCentral Nervous System Involvement Complete Remission Rate Monocytic Leukemia Central Nervous System Relapse Acute Nonlymphocytic Leukemia
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- 2.Yanai, M., Tsuji, T., Takeda, T. et al: Treatment of acute nonlymphoblastic leukemia in childhood: results of protocol ANLL-827 and ANLL-861 studies. Rinshoketsueki Jpn. J. Clin. Hematol. 28: 1752–1762,1987.Google Scholar
- 8.Geller, R.B., Saral, R., Piantadosi, S. et al.: Allogenic bone marrow transplantation after high-dose busulfan and cyclophosphamide in patients with acute nonlymphocytic leukemia. Cancer 73: 2209–2218, 1989.Google Scholar
- 9.Jonson, F.L., Sanders, J.E., Ruggiero, M., Chard, R.L. and Thomas, E.D.: Bone marrow transplantation for the treatment of acute nonlymphoblastic leukemia in children aged less than 2 years. Blood 71: 1277–1280, 1988.Google Scholar