Europ. J. Cancer Vol. 13, pp. 403-406. Pergamon Press 1977. Printed in Great Britain
Treatment of Adult Acute Myeloid Leukemia D. FIERE, P. A. BRYON, P. FELMAN, C. MARTIN, P. Y. PEAUD and L. tLEVOL Unite de Chimiotherapie, Service des maladies du sang, Hopital Edouard Herriot, Pavilion E BIS, F, 69 374 Lyon Cedex 2, France &bstractDBetween November 1974 and October 1975, 50 acute myeloid leukemias in first perceptible phase received according to their initial stade, an induction treatment either with daunorubicine vincristine cytosine arabinoside or with ¢yclophosphamide, vincristine, cytosine arabinoside in reduceddose. When, in comflete remission, patients were treated with consolidation and maintenance cyclic chemotherapy, prevention of central nervous system involvement, androgenothera~Oy and, by randomisation immunothera~Oyor not with B.C.G. An overall remission rate of 68% and 75% with daunorubieine induction regimen were obtained; it is too earlyfor the evaluation of remission duration.
THE TREATMENT of adult acute myeloid leukemia has been significantly improved during the last few years. Combination chemotherapy, improvement in supportive care, immunotherapy or other stimulating factors are responsible for better therapeutic efficiency [1-3]. We report here the preliminary results of a protocol (L 275) for the induction and prolongation of remission in acute myeloid leukemia.
state of patients and therapeutic response. Two inductions regimens were used (Table 2) : Either, three drugs: daunorubicine (DNR), vincristine (VCR) and cytosine arabinoside (CAR) were administered in a seven days course which may be prolonged or shortened according to the peripheral white blood cells count. Or in patients over 55 and/or with cardiac, hepatic or renal disease, thtts presenting a high risk of treatment failure, a five days course was
1. PATIENTS AND M E T H O D S Table 1.
(1) Patients Between November 1974 and October 1975, 50 new patients entered in our center with A.M.L. in first perceptible phase. All these patients were included. There were 27 males and 23 females whose age ranged from 15 to 78. Ten patients were over 65, of these 8 were females, and median age was 72. Other 40 patients were under 65 with a median age of 50. In all patients, bone marrow smears were classified on the basis of the subdivision of acute leukemias proposed by Mathe et al. [4]. 43 were typical myeloblastic leukemias, 5 promyelocytic leukemias, 3 myelomonocytic leukemias. Peripheral white blood cells count varied widely as shown in the Table 1 and tumoral involvement was noted in 14 patients.
White blood cell count at the onset of treatment
W.B.C. × 103
0
Patients
Table 2.
10 20
50 12
150 18
Induction remission schedule (dose in mg body
surface area) Days
1
2
3
4
5
6
7
" N o r m a l " course
Daunorubicine Vincristlne Cytosine arabinoside
60 60
60 1 240 240 240 240
" H i g h risk" course.
Cyclophosphamide 600 Vincristine Cytosine arabinoside
(2) Treatment protoeol (2.1) Remission induction. Induction treatment was modulated according to the initial
1 210 210 210 210 210
Modulation in normal course: Day 7 ff WBO ~> 1500/ m m 3. Cytosine is given on day 8 WBC ~
Treatment of Adult Acute Myeloid Leukemia D. FIERE, P. A. BRYON, P. FELMAN, C. MARTIN, P. Y. PEAUD and L. tLEVOL Unite de Chimiotherapie, Service des maladies du sang, Hopital Edouard Herriot, Pavilion E BIS, F, 69 374 Lyon Cedex 2, France &bstractDBetween November 1974 and October 1975, 50 acute myeloid leukemias in first perceptible phase received according to their initial stade, an induction treatment either with daunorubicine vincristine cytosine arabinoside or with ¢yclophosphamide, vincristine, cytosine arabinoside in reduceddose. When, in comflete remission, patients were treated with consolidation and maintenance cyclic chemotherapy, prevention of central nervous system involvement, androgenothera~Oy and, by randomisation immunothera~Oyor not with B.C.G. An overall remission rate of 68% and 75% with daunorubieine induction regimen were obtained; it is too earlyfor the evaluation of remission duration.
THE TREATMENT of adult acute myeloid leukemia has been significantly improved during the last few years. Combination chemotherapy, improvement in supportive care, immunotherapy or other stimulating factors are responsible for better therapeutic efficiency [1-3]. We report here the preliminary results of a protocol (L 275) for the induction and prolongation of remission in acute myeloid leukemia.
state of patients and therapeutic response. Two inductions regimens were used (Table 2) : Either, three drugs: daunorubicine (DNR), vincristine (VCR) and cytosine arabinoside (CAR) were administered in a seven days course which may be prolonged or shortened according to the peripheral white blood cells count. Or in patients over 55 and/or with cardiac, hepatic or renal disease, thtts presenting a high risk of treatment failure, a five days course was
1. PATIENTS AND M E T H O D S Table 1.
(1) Patients Between November 1974 and October 1975, 50 new patients entered in our center with A.M.L. in first perceptible phase. All these patients were included. There were 27 males and 23 females whose age ranged from 15 to 78. Ten patients were over 65, of these 8 were females, and median age was 72. Other 40 patients were under 65 with a median age of 50. In all patients, bone marrow smears were classified on the basis of the subdivision of acute leukemias proposed by Mathe et al. [4]. 43 were typical myeloblastic leukemias, 5 promyelocytic leukemias, 3 myelomonocytic leukemias. Peripheral white blood cells count varied widely as shown in the Table 1 and tumoral involvement was noted in 14 patients.
White blood cell count at the onset of treatment
W.B.C. × 103
0
Patients
Table 2.
10 20
50 12
150 18
Induction remission schedule (dose in mg body
surface area) Days
1
2
3
4
5
6
7
" N o r m a l " course
Daunorubicine Vincristlne Cytosine arabinoside
60 60
60 1 240 240 240 240
" H i g h risk" course.
Cyclophosphamide 600 Vincristine Cytosine arabinoside
(2) Treatment protoeol (2.1) Remission induction. Induction treatment was modulated according to the initial
1 210 210 210 210 210
Modulation in normal course: Day 7 ff WBO ~> 1500/ m m 3. Cytosine is given on day 8 WBC ~
