Treatment of Childhood Acute Nonlymphocytic Leukemia with High-Dose Cytosine Arabinoside, 6-Thioguanine, and Doxorubicin without Maintenance Therapy: Pilot Study ANLL-80 of the Dutch Childhood Leukemia Study Group (DCLSG)

Abstract

A pilot study was undertaken to determine the efficacy of remission induction therapy with 1000 mg/ m² high-dose cytosine-arabinoside (one i.v. push injection every 24 h, days 1-12), 65 mg/m² 6-thioguanine (orally, days 1-12), and 40 mg/m² doxorubicin (i.v., days 13 and 14) without maintenance or consolidation therapy as a possible cure of childhood acute nonlymphocytic leukemia. Children in first remission with a suitable donor were offered the opportunity of allogeneic bone marrow transplantation (BMT). Between March 1980 and June 1981, 24 of 27 consecutive, newly diagnosed children entered the pilot study. Complete remission was achieved in 15 (71.4%) of 21 treated patients. Eleven children received no further therapy: 9 relapsed within 5 months (all hematologically), 2 have been in longstanding continuous complete remission (CCR)for 70+ and 77+ months. Four children underwent allogeneic BMT: 2 have been in CCR for 68+ and 75+ months, 1 child died of graft-versus-host disease, and 1 child relapsed 60 months after BMT. Although the remission rate (71.4 %) was satisfactory, only a minority (18%) of the patients who received no further therapy seem to be cured.

Key Words:

• childhood acute nonlymphocytic leukemia
• high-dose cytosine arabinoside
• pilot study
• unmaintained remission