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Intensive therapy for adult acute lymphoblastic leukemia: preliminary results of the idarubicin/vincristine/L-asparaginase/prednisolone regimen.
Semin Oncol. 1993 Dec; 20(6 Suppl 8):39-46.SO

Abstract

Between June 1991 and September 1992, 80 patients with adult acute lymphoblastic leukemia (ALL) (newly diagnosed, n = 68; relapsed or refractory ALL, n = 7; lymphoid blast transformation of Philadelphia chromosome-positive chronic myelogenous leukemia [LT-CML], n = 5) were managed with a combination regimen consisting of idarubicin 36, 20, or 10 mg/m2 plus vincristine, L-asparaginase, and prednisolone (IVAP-1, -2, -3). Three patients with LT-CML and four with relapsing ALL had a complete remission. In the group of newly diagnosed patients aged 15 to 60 years treated with IVAP-1, the complete remission rate was only 44% due to the high incidence of toxic deaths. In contrast, 39 of 44 cases who subsequently received IVAP-2 achieved a complete remission (89%, P = .001), as did 62% of elderly patients who received IVAP-3. Hematologic and nonhematologic toxicity was significantly reduced with IVAP-2 compared with IVAP-1. The use of recombinant human granulocyte colony-stimulating factor in 24 patients was not associated with a reduced duration of granulocytopenia less than 0.5 x 10(9)/L, although there was a lower incidence of documented infections in patients receiving granulocyte colony-stimulating factor than in controls. Post-remission intensification with idarubicin-based courses, high-dose therapy with autologous bone marrow stem cell rescue, and rotational weekly therapy was feasible and its toxicity was manageable. These preliminary findings indicate that IVAP-2 (idarubicin 20 mg/m2) is a highly effective and well-tolerated regimen for remission induction of adult ALL.

Authors+Show Affiliations

Divisione di Ematologia, Ospedali Riuniti, Bergamo, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

7507263

Citation

Bassan, R, et al. "Intensive Therapy for Adult Acute Lymphoblastic Leukemia: Preliminary Results of the idarubicin/vincristine/L-asparaginase/prednisolone Regimen." Seminars in Oncology, vol. 20, no. 6 Suppl 8, 1993, pp. 39-46.
Bassan R, Battista R, Viero P, et al. Intensive therapy for adult acute lymphoblastic leukemia: preliminary results of the idarubicin/vincristine/L-asparaginase/prednisolone regimen. Semin Oncol. 1993;20(6 Suppl 8):39-46.
Bassan, R., Battista, R., Viero, P., Pogliani, E., Rossi, G., Lambertenghi-Deliliers, G., Rambaldi, A., D'Emilio, A., Buelli, M., & Borleri, G. (1993). Intensive therapy for adult acute lymphoblastic leukemia: preliminary results of the idarubicin/vincristine/L-asparaginase/prednisolone regimen. Seminars in Oncology, 20(6 Suppl 8), 39-46.
Bassan R, et al. Intensive Therapy for Adult Acute Lymphoblastic Leukemia: Preliminary Results of the idarubicin/vincristine/L-asparaginase/prednisolone Regimen. Semin Oncol. 1993;20(6 Suppl 8):39-46. PubMed PMID: 7507263.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intensive therapy for adult acute lymphoblastic leukemia: preliminary results of the idarubicin/vincristine/L-asparaginase/prednisolone regimen. A1 - Bassan,R, AU - Battista,R, AU - Viero,P, AU - Pogliani,E, AU - Rossi,G, AU - Lambertenghi-Deliliers,G, AU - Rambaldi,A, AU - D'Emilio,A, AU - Buelli,M, AU - Borleri,G, PY - 1993/12/1/pubmed PY - 1993/12/1/medline PY - 1993/12/1/entrez SP - 39 EP - 46 JF - Seminars in oncology JO - Semin Oncol VL - 20 IS - 6 Suppl 8 N2 - Between June 1991 and September 1992, 80 patients with adult acute lymphoblastic leukemia (ALL) (newly diagnosed, n = 68; relapsed or refractory ALL, n = 7; lymphoid blast transformation of Philadelphia chromosome-positive chronic myelogenous leukemia [LT-CML], n = 5) were managed with a combination regimen consisting of idarubicin 36, 20, or 10 mg/m2 plus vincristine, L-asparaginase, and prednisolone (IVAP-1, -2, -3). Three patients with LT-CML and four with relapsing ALL had a complete remission. In the group of newly diagnosed patients aged 15 to 60 years treated with IVAP-1, the complete remission rate was only 44% due to the high incidence of toxic deaths. In contrast, 39 of 44 cases who subsequently received IVAP-2 achieved a complete remission (89%, P = .001), as did 62% of elderly patients who received IVAP-3. Hematologic and nonhematologic toxicity was significantly reduced with IVAP-2 compared with IVAP-1. The use of recombinant human granulocyte colony-stimulating factor in 24 patients was not associated with a reduced duration of granulocytopenia less than 0.5 x 10(9)/L, although there was a lower incidence of documented infections in patients receiving granulocyte colony-stimulating factor than in controls. Post-remission intensification with idarubicin-based courses, high-dose therapy with autologous bone marrow stem cell rescue, and rotational weekly therapy was feasible and its toxicity was manageable. These preliminary findings indicate that IVAP-2 (idarubicin 20 mg/m2) is a highly effective and well-tolerated regimen for remission induction of adult ALL. SN - 0093-7754 UR - https://www.unboundmedicine.com/medline/citation/7507263/Intensive_therapy_for_adult_acute_lymphoblastic_leukemia:_preliminary_results_of_the_idarubicin/vincristine/L_asparaginase/prednisolone_regimen_ L2 - http://www.diseaseinfosearch.org/result/188 DB - PRIME DP - Unbound Medicine ER -