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Intensified therapy in acute lymphoblastic and acute undifferentiated
leukemia in adults
D Hoelzer, E Thiel, H Loffler, H Bodenstein, L Plaumann, T Buchner, D Urbanitz, P Koch, H Heimpel and R Engelhardt
One hundred seventy adult patients with acute lymphoblastic leukemia (ALL)
or acute undifferentiated leukemia (AUL) were entered into a prospective
multicenter therapy trial at 25 hospitals. The aim of the trial was to
improve remission duration by using a modified form of an intensified
induction regimen that was successful in childhood ALL, to define
immunologic subtypes of ALL by use of cell-surface markers, and to extract
other possible prognostic factors. The overall complete remission rate was
77.8%. The median overall survival time was 26 months, being 4 months for
nonresponders and 32 months for responders. The median remission duration
for the 126 patients with complete remission was 20 months. Prognostically
favorable factors for remission duration were response to chemotherapy
within 4 weeks, age less than 35 years, a low initial leukocyte count, and
the immunologic subtypes c- ALL with early response to therapy and T-ALL,
where 61% and 58%, respectively, are still in complete remission at 3
years. An adverse influence on remission duration was observed for the
subtype null-ALL, with a median survival of 13 months, and for patients
with a delayed response to induction therapy, independent of phenotype.
Volume 64,
Issue 1,
pp. 38-47,
07/01/1984
Copyright © 1984 by The American Society of Hematology
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