Randomized multicentric italian study on two treatment regimens for marrow relapse in childhood acute lymphoblastic leukemia

Mario Renato Rossi, Giuseppe Masera, Maria Grazia Zurlo, Sergio Amadori Grazia Zurlo, Serenella Bagnulo, Modesto Carli, Luigi Zanesco, Giorgio Dini, Carlo Guazzelli, Alessandro Rosi, Enrico Madon, Luigi Nespoli, Guido Paolucci, Andreaa Pession, Paolo Tamaro

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This paper reports the results of a multicentric randomized clinical trial on the treatment of first hematological relapse in childhood ALL. Induction treatment consisted of vincristine, adriamycin, L-asparaginase, and prednisone. Patients achieving complete remission were randomized to two maintenance regimens (A and B). Regimen A consisted of five different drug associations including VM26 and IDMTX in a sequential schedule; Regimen B was essentially classical Spiers schedule for the first year, followed by a milder treatment. Eighty-four of 102 evaluahle patients (82% achieved second complete remission. The two maintenance regimens were similar as regards duration of second complete remission (median duration A, 32 weeks; B, 37 weeks) and toxicity. Better results were obtained in patients relapsing after 12 months from suspension of treatment in first complete remission than in those relapsing within the first year off therapy (82.8% vs. 31.4% In group A fewer CNS relapses were reported. The two regimens produced results similar to those reported by other authors. The good prognosis in patients relapsing at least 1 year after treatment suspension in first complete remission must be emphasized.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalPediatric Hematology and Oncology
Issue number1
Publication statusPublished - 1986


  • Childhood ALL
  • Marrow relapse
  • Treatment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology
  • Cancer Research
  • Management of Technology and Innovation


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