THE INFLUENCE OF MAXIMUM SUPPORTIVE CARE ON DOSE COMPLIANCE AND SURVIVAL - SINGLE-CENTER ANALYSIS OF CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIAAND NON-HODGKINS-LYMPHOMA TREATED WITHIN 1984-1993

Background The administration of intensive, risk-adapted multiagent ch emotherapy has markedly improved the event-free survival in childhood acute lymphoblastic leukemia and Non-Hodgkin's lymphoma. Current treat ment protocols may achieve complete remission rates of more than 95% a nd event-free survival rates of approximately 70% in non-B-acute lymph oblastic leukemia/non-B-Non-Hodgkin's lymphoma Fa tients. Due to a hig her proliferation rate and aggressiveness of B-cells treatment of B-ac ute lymphoblastic leukemia/B-Non-Hodgkin's lymphoma must be more inten sive, but can be shorter to attain similar event-free survival rates. Methods Between 1984 and 1993 79 primarily admitted patients up to 18 years of age (range 0.6-17.9 years) received therapy according to the treatment protocols ALL A 84, ALL 86, NHL 86, ALL 90 and NHL 90 of the Berlin-Frankfurt-Munster Study Group. Intensive phases of treatment w ere given on an inpatient basis with maximum supportive care in order to achieve the prescribed doses. Results Median follow-up time from di agnosis is now 8 years (range 40 to 157 months) with a probability of event-free survival of 92% for the entire group. Conclusion Multiagent chemotherapy tailored to the individual risk profile of each patient but given in the prescribed dose is currently the mainstay to achieve high complete remission rates with the aim to cure most acute lymphobl astic leukemia/Non-Hodgkin's lymphoma patients. The administration of intensive supportive care is important for the achievement of complete drug dos age and for the reduction of therapy-related toxicity.