Induction of remission with l‐asparaginase, cyclophosphamide, cytosine arabinoside, and prednisolone in adult patients with acute leukemia

Abstract

Seventy‐one adults with acute leukemia were randomized for treatment with a combination of cyclophosphamide, cytosine arabinoside, and prednisolone, with (CAPA) or without (CAP) the addition of L‐asparaginase. Remissions were induced with CAPA in 9 patients (33%) with AML, and 8 patients (67%) with ALL, and with CAP in 10 patients (40%) with AML, and 4 patients (57%) with ALL. Thus, the addition of L‐asparaginase did not improve the response significantly. The over‐all complete remission rate was significantly higher in females (45%) than in males (23%), and the rate below 50 years of age tended to be higher (45%) than above this age (27%). There was a slight tendency for a longer first remission time in AML with L‐asparaginase (284 days) than without (74 days), but no such difference between the two ALL groups. Hyper‐sensitivity reactions, nausea, vomiting, psychiatric disturbances, and liver dys‐function were more common side effects in patients treated with L‐asparaginase. Copyright © 1974 American Cancer Society