VM‐26 and cytosine arabinoside combination chemotherapy for initial induction failures in childhood lymphocytic leukemia

Abstract

Combination chemotherapy with VM‐26 and ara‐C was given to 14 children with acute lymphocytic leukemia who had not responded to initial treatment with prednisone, vincristine, daunomycin, and asparaginase. Nine of these patients had also received ara‐C. At diagnosis, five children were classified as having standard prognostic features and nine as being at high risk for treatment failure. The drug combination was administered by vein twice a week for four weeks at dosages of 165 mg/m2 for VM‐26 and 300 mg/m2 for ara‐C. Nine complete remissions, five in patients with high‐risk leukemia, were induced with acceptable toxicity; all 9 subsequently were given continuation therapy with oral mercaptopurine and methotrexate. Four of the 9 patients have relapsed at 2–21 months. All treatment was stopped in 2 patients after 30 months of complete remission. Combinations of VM‐26 and ara‐C represent an alternative remission induction treatment for patients who fail to attain initial remission with agents of established effectiveness. These agents may especially benefit patients with prognostic features indicating a high risk of treatment failure. Copyright © 1980 American Cancer Society