Acute lymphoblastic leukaemia in adults in Sweden 1977–84: A retrospective analysis

Abstract

The present study is a retrospective analysis of the outcome in 210 patients diagnosed and treated as having acute lymphoblastic leukaemia (ALL) in Sweden during 1977–84. 131 patients were morphologically rediagnosed as ALL. For the ALL‐patients, nine different remission induction regimens were used. Remission frequency was 69%, without statistical difference according to induction treatment. However, the reasons for remission failure differed among therapy groups. The number of responders was significantly higher among patients who received a remission induction therapy with an anthracycline and/or L‐asparaginase. Maintenance therapy consisted in most cases of 6‐mercaptopurine and methotrexate with reinduction courses for 2–3 years. Median survival time was 13 months and median duration of first remission (MRD) 11 months. For a subgroup of patients (n = 29) treated with the most intense remission induction regimens, including at least 4 cytostatic drugs with both an anthracyclilne and L‐asparaginase, the MRD is not yet reached, the shortest follow up time is 43 + months, and the probability of remaining in complete remssion is 66%. We conclude that aggressive cytostatic therapy, with induction regimens including both an anthracycline and L‐asparaginase, may cure a considerable number of adult ALL‐patients. © Munksgaard 1989