Skip to main content

Current Status of Treatment of Acute Leukemia in Adults: An Overview

  • Conference paper
Therapie der akuten Leukämien

Zusammenfassung

The excellent progress which has been made during the last 3 decades in the treatment of acute lymphoblastic leukemia (ALL) in children is well known, and it appears that about half of children with ALL are now probably being cured with the best therapeutic programs [1–4]. Using the same or similar treatment protocols, the results of treatment of adults with ALL have generally been less favorable, especially with regard to the proportion of long survivors [5–15], but recently several groups, including our own, have reported improved results with intensive treatment regimens which are more nearly comparable to those in children [16–21].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. George SL, Aur RJA, Mauer A, Simone JV (1979) A reappraisal of the results of stopping therapy in childhood leukemia. NEJM 300:269–273

    Article  PubMed  CAS  Google Scholar 

  2. Haghbin M, Murphy ML, Tan CC, Clarkson BD, Thaler HT, Passe S, Burchenal JH (1980) A long-term clinical follow-up of children with acute lymphoblastic leukemia treated with intensive chemotherapy regimens. Cancer 46:241–252

    Article  PubMed  CAS  Google Scholar 

  3. Riehm H, Gadner H, Henze G, Langermann HJ, Odenwald E (1980) The Berlin childhood acute lymphoblastic leukemia therapy study, 1970–1976. Am J Pediatr Hematol Oncol 2:299

    Google Scholar 

  4. Nesbit ME, Sather H, Robison LL, Donaldson M, Littmann P, Ortega JA, Hammond GD (1982) Sanctuary Therapy: A randomized trial of 724 children with previously untreated acute lymphoblastic leukemia. A report from Childrens Cancer Study Group. Cancer Res 42:674–680

    PubMed  CAS  Google Scholar 

  5. Gee TS, Haghbin M, Dowling MD, Cunningham I, Middleman MP, Clarkson BD (1976) Acute lymphoblastic leukemia in adults and children. Differences in response with similar therapeutic regimens. Cancer 37:1256–1264

    Article  PubMed  CAS  Google Scholar 

  6. Sackmann-Muriel F, Svarch E, Eppinger-Helft M, Braier JL, Pavlovsky S, Guman L, Ver-gara B, Ponzinibbio C, Failace R, Garay GE, Bugnard E, Ojeda FG, Bellis Rde, Sijvarger SR de, Saslavsky J (1978) Evaluation of intensification and maintenance programs in the treatment of acute lymphoblastic leukemia. Cancer 42:1730

    Article  PubMed  CAS  Google Scholar 

  7. Jacquillat C, Weil M, Auclerc MF, Chastang C, Flandrin G, Izrael V, Schaison G, Degos L, Boiron M, Bernard J (1978) Prognosis and treatment of acute lymphoblastic leukemia. Study of 650 Patients. Cancer Chemother Pharmacol 1:113

    Article  PubMed  CAS  Google Scholar 

  8. Lister TA, Whitehouse JMA, Beard MEJ, Brearley RL, Wrigley PM, Oliver RTD, Freeman JE, Woodruff RK, Malpas JS, Paxton AM, Crowther D (1978) Combination chemotherapy for acute lymphoblastic leukemia in adults. Br Med J 1:199

    Article  PubMed  CAS  Google Scholar 

  9. Henderson ES, Scharlau C, Cooper MR, Haurani FI, Brunner K, Carey RW, Falkson G, Nawabi IV, Levine AS, Bank A, Cuttner J, Cornwell CG, Henry P, Nissen NI, Wiernik PH, Leone L, Wohl H, Rai K, James GW, Weinberg V, Glidewell O, Holland JF (1979) Combi¬nation chemotherapy and radiotherapy for acute lymphocytic leukemia in adults: results of CALGB protocol 7113. Leuk Res 3:395

    Article  PubMed  CAS  Google Scholar 

  10. Amadori S, Montuoro A, Meloni G, Spiriti MAA, Pacili, L, Mandelli F (1980) Combination chemotherapy for acute lymphocytic leukemia in adults: results of a retrospective study in 82 patients. Am J Hematol 8:175

    Article  Google Scholar 

  11. Brun B, Vernant JP, Tulliez M, Kuentz M, Deregnaucourt J, Shultze L, Reyes F, Rochant H, Dreyfus B (1980) Acute non myeloid leukemia in adults. Prognostic factors in 92 patients. Scand J Haematol 24:29

    Article  PubMed  CAS  Google Scholar 

  12. Omura GA, Moffitt S, Vogler WR, Salter MM (1980) Combination chemotherapy of adult acute lymphoblastic leukemia with randomized central nervous system prophylaxis. Blood 55:199

    PubMed  CAS  Google Scholar 

  13. Willemze R, Drenthe-Schonk AM, van Rossum J, Haanen C (1980) Treatment of acute lymphoblastic leukaemia in adolescents and adults. Comparison of two schedules for CNS leukaemia prophylaxis. Scand J Haematol 24:421–426

    Article  Google Scholar 

  14. Leimert JT, Burns CP, Wiltse CG, Armitage JO, Clarke WR (1980) Prognostic influence of pre treatment characteristics in adult acute lymphoblastic leukemia. Blood 56:510

    PubMed  CAS  Google Scholar 

  15. Baccarani M, Corbelli G, Amadori S, Drenthe-Schonk A, Willemze R, Meloni G, Cardozo PL, Haanen C, Mandelli F, Tura S (1982) Adolescent and adult acute lymphoblastic leukemia: Prognostic features and outcome of therapy. A study of 293 patients. Blood 60:77–684

    Google Scholar 

  16. Blacklock HA, Matthews JRD, Buchanan JG, Ockelford PA, Hill RS (1981) Improved survival from acute lymphoblastic leukemia in adolescents and adults. Cancer 48:1931–1935

    Article  PubMed  CAS  Google Scholar 

  17. Clarkson B, Schauer P, Mertelsmann R, Gee T, Arlin Z, Kempin S, Dowling M, DuFour P, Cirrincione C, Burchenal JH (1981) Results of intensive treatment of acute lymphoblastic leukemia in adults. In: Burchenal JH and Oettgen H (eds) Cancer: Achievements, Challenges and Prospects for the 1980’s, Vol 2, Grune & Stratton, Inc, New York, pp 301–317

    Google Scholar 

  18. Esterhay RJ, Wiernik PH, Grove WR, Markus SD, Wesley MN (1982) Moderate dose methotrexate, vincristine, asparaginase, and dexamethasone for treatment of adult acute lymphocytic leukemia. Blood 59:334–345

    PubMed  Google Scholar 

  19. Amadori S, Meloni G, Baccarani M, Haanen C, Willemze R, Corvelli G, Drenthe-Schonk A, Cardozo PL, Tura S, Mandelli F (1983) Long-term survival in adolescent and adult acute lymphoblastic leukemia. Cancer 52:30–34

    Article  PubMed  CAS  Google Scholar 

  20. Schauer P, Arlin ZA, Mertelsmann R, Cirrincione C, Friedman A, Gee TS, Dowling M, Kempin S, Straus DJ, Koziner B, McKenzie S, Thaler HT, DuFour P, Little C, Dellaquila C, Ellis S, Clarkson B (1983) Treatment of acute lymphoblastic leukemia in adults. Results of the L-10 and L-10 M protocols. J Clin One 1:462–470

    CAS  Google Scholar 

  21. Clarkson B, Arlin Z, Gee T, Mertelsmann R, Kempin S, Higgins C, Little C, Cirrincione C (1983) Improved treatment of acute lymphoblastic leukemia (ALL) in adults. Proc Arner Soc Clin One 2:180

    Google Scholar 

  22. Chard RI, Finkelstein JZ, Sonley MJ, Nesbit M, McCreadie S, Weiner J, Sather H, Hammond D (1978) Increased survival in childhood acute non-lymphocytic leukemia after treatment with prednisone, cytosine arabinoside, 6-thioguanine, cyclophosphamide, and oncovin (PATCO) combination chemotherapy. Med Pediatr Oncol 4:263–273

    Article  PubMed  Google Scholar 

  23. Dahl GV, Simone JV, Hustu HO, Mason C (1978) Preventive central nervous system ir¬radiation in children with acute non-lymphocytic leukemia. Cancer 42:2187–2192

    Article  PubMed  CAS  Google Scholar 

  24. Weinstein HJ, Mayer RJ, Rosenthal DS, Coral FS, Camitta BM, Gelber RD (1983) Chemotherapy for acute myelogenous leukemia in children and adults: VAPA update. Blood 62:315–319

    CAS  Google Scholar 

  25. Clarkson BD, Dowling MD, Gee TS, Cunningham IB, Burchenal JH (1975) Treatment of acute leukemia in adults. Cancer 36:775–795

    Article  PubMed  CAS  Google Scholar 

  26. Carey RW, Ribas-Mundo M, Ellison RR, Glidwell O, Lee ST, Cuttner J, Levy RN, Silver R, Blom J, Havrani F, Spurr CL, Harley JB, Kyle R, Moon JH, Eagan RT, Holland JH (1975) Comparative study of cytosine arabinoside therapy alone and combined with thio- guanine, mercaptopurine, or daunorubicin in acute myelocytic leukemia. Cancer 36:1560–1566

    Article  PubMed  CAS  Google Scholar 

  27. Medical Research Council (1979) Chemotherapy of acute myeloid leukemia in adults. Brit J Cancer 39:69

    Article  Google Scholar 

  28. Gale RP, Foon FA, Cline MJ, Zighelboim J, and the UCLA Acute Leukemia Study Group (1981) Intensive chemotherapy for acute myelogenous leukemia. Ann Intern Med 94:753–757

    Google Scholar 

  29. Rai KR, Holland JF, Glidewell OJ, Weinberg V, Brunner K, Obrecht JP, Reisler HD, Nwabi JW, Prager D, Carey RW, Cooper MR, Havrani F, Hutchison JL, Silver RT, Galk-son G, Wiernik P, Hoagland C, Bloomfield CD, James GW, Gottlieb A, Ramanan SV, Blom J, Nissen NI, Bank A, Ellison RR, King F, Henry P, Mclntyre OR, Kaan SK (1981) Treatment of acute myelocytic leukemia: A study by Cancer and Leukemia Group B. Blood 58:1203–1212

    Google Scholar 

  30. Keating MJ, McCredie KB, Bodey GP, Smith TL, Gehan E, Freireich EJ (1982) Improved prospects for long-term survival in adults with acute myelogenous leukemia. JAMA 248:2481–2486

    Article  PubMed  CAS  Google Scholar 

  31. Peterson BA, Bloomfield CC (1981) Long-term disease-free survival in acute nonlympho- eytic leukemia. Blood 57:1144–1147

    PubMed  CAS  Google Scholar 

  32. Lister TA, Whitehouse J MA, Oliver TRD, Bell R, Johnson SA, Wrigley PF, Ford JM, Gul¬len MH, Gregory W, Paxton AM, Malpas JS (1980) Chemotherapy and immunotherapy for acute myelogenous leukemia. Cancer 46:2142–2148

    Article  PubMed  CAS  Google Scholar 

  33. Mertelsmann R, Drapkin RL, Gee TS, Kempin S, Passe S, Thaler HT, Arlin Z, Dowhng MD, DuFour P, McKenzie S, To L, Camacho E, Oettgen HF, Burchenal JH, Clarkson B (1981) Treatment of acute nonlymphocytic leukemia in adults: Response to 2,2-anhydro- l-B-D-arabinofuranosyl-5-fluorocytosine and thioguanine on the L-12 protocol. Cancer 48:2136–2142

    Article  PubMed  CAS  Google Scholar 

  34. Passe S, Mike V, Mertelsmann R, Gee TS, Clarkson B (1982) Acute non-lymphoblastic leukemia: Prognostic factors in adults with long term follow-up. Cancer 50:1462–1471

    Google Scholar 

  35. Arlin Z, Clarkson B (1983) The treatment of acute nonlymphoblastic leukemia in adults. In: Stollerman GH (ed) Advances in Internal Medicine, Vol 28, Year Book Medical Publishers, Inc, New York, pp 303–323

    Google Scholar 

  36. Clarkson BD, Fried J (1971) Changing concepts of treatment in acute leukemia. Med Clin NAmer 55:561–600

    CAS  Google Scholar 

  37. Clarkson BD, Haghbin M, Murphy ML, Gee TS, Dowhng MD, Arlin ZA, Kempin S, Posner J, Shapiro W, Galicich J, DuFour P, Passe S, Burchenal JH (1979) Prevention of cen¬tral nervous system leukemia in acute lymphoblastic leukemia with prophylactic chemo¬therapy alone. In: Whitehouse JMA, Kay HEM (eds), CNS Complications of Malignant Disease, MacMillans, London, pp 36–58

    Google Scholar 

  38. Clarkson B, Chou T-C, Strife A, Ferguson R, Sullivan S, Fried J, Kitahara T, Oyama A (1977) Duration of the dormant state in an established cell line of human hematopoietic cells. Cancer Res 37:4506–4522

    PubMed  CAS  Google Scholar 

  39. Arlin ZA, Gee TS, Mertelsmann R, Kempin S, Cirrincione C, Higgins C, Clarkson BD (1983) Treatment of acute lymphoblastic leukemia (ALL) in adults: Comparability of results using extended and brief consolidation therapy. Proc Amer Assoc Cancer Res 24:119

    Google Scholar 

  40. Conjalka M, Jhanwar S, Mertelsmann R, Arlin Z, Koziner B, Chaganti R, Finkbeiner J, Clarkson B (1983) Pretreatment marrow cytogenetic findings in adult acute lymphoblastic leukemia help predict outcome of treatment. Proc Amer Soc Clin One 2:183

    Google Scholar 

  41. Jain K, Arlin Z, Mertelsmann R, Gee T, Kempin S, Koziner B, Middleton A, Jhanwar S, Chaganti R, Clarkson B (1983) Philadelphia chromosome and terminal transferase positive acute leukemia: Similarity of terminal phase of chronic myelogenous leukemia and de novo acute presentation. J Clin One 1:669–676

    CAS  Google Scholar 

  42. Gee TS, Yu K-P, Clarkson B (1969) Treatment of adult acute leukemia with arabinosyl cytosine and thioguanine. Cancer 23:1019–1032

    Article  PubMed  CAS  Google Scholar 

  43. Arlin ZA, Flomenberg N, Gee TS, Kempin SJ, Dellaquilla C, Mertelsmann R, Straus DJ, Young CW, Clarkson B (1981) Treatment of acute leukemia in relapse with 4’(9-acridinyl- amino)methanesulfon-m-anisidide (AMSA) in combination with cytosine arabinoside and thioguanine. Cancer Clin Trials 4:317–321

    PubMed  CAS  Google Scholar 

  44. Arlin ZA, Gee TS, Mertelsmann R, Kempin SJ, Reich LM, Straus DJ, Higgins C, Clarkson B (1983) Randomized trial of 4’(9-acridinylamino)methanesulfon-m-anisidide (AMSA) in combination with cytosine arabinoside (Ara-C) and thioguanine (TG) vs. daunorubicin with Ara-C and TG in adults with acute non-lymphoblastic leukemia (ANLL). In: Bodey GP and Jacquillat CL (eds) Current Prospectives and Clinical Results with a New AntiCancer Agent, Princeton Communications Medicine for Education, Princeton, New Jersey, pp 77–84

    Google Scholar 

  45. Jacquillat CL, Weil M, Gemon MF (1973) Evaluation of 216 four-year survivors of acute leukemia. Cancer 32:286–293

    Article  PubMed  CAS  Google Scholar 

  46. Whittaker JA, Reizenstein P, Callender ST (1981) Long survival in acute myelogenous leukaemia: An international collaborative study. Brit Med J 282:692–695

    Article  CAS  Google Scholar 

  47. Mertelsmann R, Moore MAS, Clarkson B (1982) Leukemic cell phenotype and prognosis: An analysis of 519 adults with acute leukemia. Blood Cells 8:561–583

    PubMed  CAS  Google Scholar 

  48. Keating MJ, Smith TL, Gehan EA, McCredie KB, Bodey GP, Spitzer G, Hersh E, Gut-terman J, Freireich EJ (1980) Factors related to length of complete remission in adult acute leukemia. Cancer 45:2017–2029

    Article  PubMed  CAS  Google Scholar 

  49. Hiddemann W, Büchner T, Andreeff M, Wörmann B, Melamed MR, Clarkson B (1982) Cell kinetics in acute leukemia. A critical re-evaluation based on new data. Cancer 50:250–258

    Article  PubMed  CAS  Google Scholar 

  50. Mertelsmann R, Koziner B, Ralph P, Filippa D, McKenzie S, Arlin ZA, Gee TS, Moore MAS, Clarkson B (1978) Evidence for distinct lymphocytic and monocytic populations in a patient with terminal transferase positive acute leukemia. Blood 51:1051

    PubMed  CAS  Google Scholar 

  51. Bradstock KF, Hoffbrand AV, Ganeshaguru K, Llewellin P, Patterson K, Wonke B, Prentice AG, Bennett M, Pizzolo G, Bollum FJ, Janossy G (1981) Terminal deoxynucleotidyl transferase expression in acute non-lymphoid leukemia: An analysis by immuno¬fluorescence. Brit J Hematol 47:133

    Article  CAS  Google Scholar 

  52. Fialkow PJ, Singer JW, Adamson JW, Vaidya K, Dow LW, Ochs J, Moohr JW (1981) Acute non-lymphocytie leukemia: Heterogeneity of stem cell origin. Blood 57:1068

    PubMed  CAS  Google Scholar 

  53. Benedetto P, Mertelsmann RH, Ciobanu N, Gee T, Arlin Z, Kempin S, Clarkson B (1982) Prognostic significance of terminal deoxynucleotidyl transferase (TdT) activity in acute non-lymphoblastic leukemia (ANLL): Evidence for biphenotypic leukemias. Proc Amer Assoc Cancer Res 23:115

    Google Scholar 

  54. Smith LJ, Curtis JE, Messner HA, Senn JS, Furthmayr H, McCulloch EA 1982 or 1983. Lineage infidelity in acute leukemia. Blood 61:1138–1145

    Google Scholar 

  55. Moore MAS, Spitzer G, Williams N, Metealf D, Buckley J (1974) Agar culture studies in 127 cases of untreated acute leukemia: The prognostic value of re-classification of leukemia according to in vitro growth characteristics. Blood 44:1

    PubMed  CAS  Google Scholar 

  56. Mertelsmann R, Moore MAS, Broxmeyer HE, Cirrineione C, Clarkson BD (1981) The diagnostic and prognostic significance of the CFU-c assay in acute non-lymphoblastic leukemia (ANLL). Cancer Res 41:4844

    PubMed  CAS  Google Scholar 

  57. McCulloch EA, Curtis JE, Messner HA, Senn JS, Germanson TP (1982) The contribution of blast cell properties to outcome variation in acute myeloblastic leukemia (AML). Blood 59:601

    PubMed  CAS  Google Scholar 

  58. Rowley JD (1981) Association of specific chromosome abnormalities with type of acute leukemia and with patient age. Cancer Res 41:3407

    PubMed  CAS  Google Scholar 

  59. Arlin Z, Kempin S, Mertelsmann R, Gee T, Higgins C, Clarkson B (1983) Primary therapy of acute promyelocytic leukemia: Results of amsacrine and daunorubicin-based therapy. Blood 63:211–212, 1984

    Google Scholar 

  60. Hoelzer D, Thiel E, Löffler H, Bodenstein H, Plaumann L, Büchner T, Urbanitz D, Koch P, Heimpel H, Engelhardt R, Müller U, Wendt F-C, Sodomann H, Rühl H, Herrmann F, Kaboth W, Dietzfelbinger H, Pralle H, Lunscken Ch, Hellriegel K-P, Spors S, Nowrousian RM, Fischer J, Fülle H, Mitrou PS, Pfreundschuh M, Gorg Ch, Emmerich B, Queisser W, Meyer P, Labedzki L, Essers U, König H, Mainzer K, Herrmann R, Messerer D, Zwingers T, Intensified therapy in acute lymphoblastic and acute undifferentiated leukemia in adults. Blood 64:38–47, 1984

    PubMed  CAS  Google Scholar 

  61. Arlin Z, Mertelsmann R, Kempin S, Gee T, Clarkson B (1982) Is further intensification of treatment warranted in acute nonlymphoblastic leukemia? Cancer Treat Rep 67:202–204

    Google Scholar 

  62. Preisler HD (1982) Therapy for patients with acute myelocytic leukemia who enter remis¬sion: bone marrow transplantation or chemotherapy? Cancer Treat Rep 66:1467–1473

    PubMed  CAS  Google Scholar 

  63. Glucksberg H, Cheever MA, Farewell VT, Fefer A, Thomas ED (1983) Intensification therapy for acute nonlymphoblastic leukemia in adults. Cancer 52:198–205

    Article  PubMed  CAS  Google Scholar 

  64. Rees JKH, Sandler RM, Challener J, Hayhoe FGJ (1977) Treatment of acute myeloid leukemia with a triple cytotoxic regime: DAT. Brit J Cancer 36:770–776

    Article  PubMed  CAS  Google Scholar 

  65. Thomas ED, Buckner CD, Clift RA (1979) Marrow transplantation for acute nonlymphoblastic leukemia in first remission. N Engl J Med 301:597–599

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1984 Springer: Berlin Heidelberg

About this paper

Cite this paper

Clarkson, B. et al. (1984). Current Status of Treatment of Acute Leukemia in Adults: An Overview. In: Büchner, T., Urbanitz, D., van de Loo, J. (eds) Therapie der akuten Leukämien. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69934-4_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-69934-4_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-13682-8

  • Online ISBN: 978-3-642-69934-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics