Impact of reinduction regimens for relapsed and refractory acute lymphoblastic leukemia in adults

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25 Citations (Scopus)

Abstract

The clinical outlook for adults with acute lymphoblastic leukemia (ALL) has improved with the use of intensive chemotherapy. Complete remissions (CR) are achieved in 80% of adults but the majority relapse on maintenance chemotherapy and a few exhibit primary resistance to induction therapy. This report compares the various salvage treatments and provides guidance in selecting a regimen with the optimum clinical outcome. Regimens using high- dose ara-C (HDAC) in combination with mitoxantrone, amsacrine, or idarubicin are superior to HDAC alone or with L-asparaginase. The sequential administration of methotrexate and L-asparaginase is equally effective. The duration of second CR is short for all chemotherapeutic regimens.

Original languageEnglish (US)
Pages (from-to)341-344
Number of pages4
JournalAmerican Journal of Hematology
Volume45
Issue number4
StatePublished - 1994

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Asparaginase
Cytarabine
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Maintenance Chemotherapy
Amsacrine
Idarubicin
Salvage Therapy
Mitoxantrone
Methotrexate
Recurrence
Drug Therapy
Therapeutics

Keywords

  • acute lymphoblastic leukemia
  • reinduction regimens
  • remission
  • treatment

ASJC Scopus subject areas

  • Hematology

Cite this

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AB - The clinical outlook for adults with acute lymphoblastic leukemia (ALL) has improved with the use of intensive chemotherapy. Complete remissions (CR) are achieved in 80% of adults but the majority relapse on maintenance chemotherapy and a few exhibit primary resistance to induction therapy. This report compares the various salvage treatments and provides guidance in selecting a regimen with the optimum clinical outcome. Regimens using high- dose ara-C (HDAC) in combination with mitoxantrone, amsacrine, or idarubicin are superior to HDAC alone or with L-asparaginase. The sequential administration of methotrexate and L-asparaginase is equally effective. The duration of second CR is short for all chemotherapeutic regimens.

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