4-AGENT INDUCTION CONSOLIDATION THERAPY FOR CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA - AN INDIAN EXPERIENCE

During 1984-1986, a total of 128 children with acute lymphoblastic leu kemia (ALL) were treated with an induction-consolidation regimen consi sting of doxorubicin, vincristine, cytosine-arabinoside, and prednisol one. One hundred two (80%) patients belonged to high-risk group. The c omplete remission rate for all the patients was 91%. The event-free su rvival at 5 years was 32.0% +/- 23%. On multivariate analysis the even t-tree survival and disease-tree survival was not altered by age, sex, WBC count, platelet count, LDH level. and surface phenotype. Infectio n due to prolonged marrow aplasia was a common complication, leading t o mortality of 8 patients during induction and 33 patients during firs t remission. The relapse rate has been 36% (42 patients). The predomin ance of high-risk ALL in the Indian population underscores the need fo r intensive therapy. Improved supportive care during induction and rem ission seems essential to decrease therapy-related mortality, leading to improved survival.