[Duration of chemotherapy in acute lymphoblastic leukemia of childhood (author's transl)]

Abstract

Most of criteria on duration of chemotherapy in acute lymphoblastic leukemia of children are based upon the prolonged state of complete remission (CR). Twenty five cases of 30 months CR duration were studied for their follow-up. Maintenance therapy in these patients was made according to two modalities. The first one was a cyclic single therapy with no prophylactic CNS treatment and the other was a combination chemotherapy method including periodical reinductions and i.t. administration of methotrexate. Most of the 30 month remissions (twenty) were attained by the last method. Until now evolution of the 25 patients has been as follows. Two died, being in CR, by infectious diseases. Eleven more suffered relapses, most of them in the following year. The other twelve patients remain in the initial CR. Chemotherapy was supressed in 10 patients (in seven at 36 months and in three at 48 months) starting then BCG immunotherapy. Three of these children suffered relapses a few months after suppression. Seven others are in remission of 47 months median duration. In other five patients, chemotherapy was not interrupted. Two died by infectious diseases and other three have relapsed. Even though the experience is too short in order to establish any conclusion, results obtained until now appear to favor suppression of chemotherapy after 30 to 36 months in patients remaining in CR.