The Effectiveness of Combinations of Antileukemic Agents in Inducing and Maintaining Remission in Children with Acute Leukemia |
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Authors: | FREI, EMIL, III KARON, MYRON LEVIN, ROBERT H. FREIREICH, EMIL J. TAYLOR, ROBERT J. HANANIAN, JULIET SELAWRY, OLEG HOLLAND, JAMES F. HOOGSTRATEN, BARTH WOLMAN, IRVING J. ABIR, ESSHAGH SAWITSKY, ARTHUR LEE, STANLEY MILLS, STEPHAN D. BURGERT, E. OMER, JR. SPURR, CHARLES L. PATTERSON, RICHARD B. EBAUGH, FRANKLIN G. JAMES, G. WATSON, III MOON, JOHN H. |
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Affiliation: | 1 Medicine Branch, National Cancer Institute, National Institutes of Health, Bethesda,Md. 2 Medicine Branch, National Cancer Institute, National Institutes of Health,Bethesda, Md. 3 Deceased. 4 Department of Pediatrics and Medicine A, Roswell Park Memorial Institute, New YorkState Department of Health, Buffalo, N. Y. 5 Mount Sinai Hospital, New York, N. Y. 6 Children’s Hospital of Philadelphia, Philadelphia, Pa. 7 Department of Medicine, Maimonides Hospital of Brooklyn, Brooklyn, New York 8 Mayo Clinic, Rochester, Minnesota 9 Bowman Gray School of Medicine, Winston-Salem, North Carolina 10 Hitchcock Hospital, Dartmouth Medical School, Hanover, New Hampshire 11 Medical College of Virginia, Richmond, Virginia
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Abstract: | 1. Combinations of effective agents produce at least an additive increase in complete remission rates over that which can be achieved when the agents are used individually.2. Patients who do not achieve complete remission with initial treatment have a significantly shorter survival.3. Alternating MTX and 6-MP at 28-day intervals during remission does not prolong the duration of remission over that of combined concurrent 6-MP and MTX.4. The administration of folic acid antagonists intrathecally at 28-day intervals during antimetabolite maintained remission did not prolong the duration of remission. Meningeal leukemia, however, occurred significantly less frequently in these patients.5. The duration of combined 6-MP and MTX maintained remission is not greater than that of 6-MP maintained remission.6. The toxicity of 6-MP and MTX in combination in patients in remission is additive.The above conclusions were drawn from this comparative study of combinations of chemotherapeutic agents in children with acute lymphocytic leukemia. Submitted on September 11, 1964 Accepted on February 23, 1965 |
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