FACTORS THAT INFLUENCE HEMATOLOGICAL REMISSION DURATION IN ACUTE LYMPHOCYTIC LEUKEMIA

The most serious immediate problem facing modern therapy is its inability to prevent hematological relapse in 1/3-2/3 of patients. When hematological relapse occurs in patients receiving chemotherapy at the time, the chance for survival is virtually eliminated. Studies have clearly established the necessity of continuing therapy during remission, the superiority of intermittent over daily methotrexate administration and the value of giving maximum-tolerated doses of chemotherapy. Data from an analysis of factors influencing hematological remission duration in 4 consecutive total therapy studies of ALL [acute lymphocytic leukemia] were given. To quantify the hematological relapse rate for each study and subgroup, the regression coefficient was derived by the least squares method from the proportion of patients remaining in hematological remission at 6 mo. intervals. Children with ALL should either be given a 3rd drug (daunorubicin or asparaginase) to vincristine and prednisone for remission induction or given an intensive phase of chemotherapy early in remission.