Abstract:OBJECTIVE: To compare the complete remission (CR) and continuous complete remission (CCR) resulting from two different treatment regimes for childhood acute lymphoblastic leukemia (ALL) and to explore the factors that could affect the long term survival of ALL patients. METHODS: Forty four patients were divided into two groups according to the chemotherapeutic regimes. In the conventional chemotherapy group (Group A, n=12), VCP(VCR, CTX, Pred) was used in remission induction therapy; MTX and Ara C were used in prophylactic therapy of extramedullary leukemia; 6 MP and MTX were used in maintenance therapy; and VCP and COAP (VCR, CTX, DXM and Pred) were used alternatively in consolidation and intensification. In the intensified chemotherapy group (Group B, n=32 ), the recommended regime for treating ALL laid down at the Beihai Convention in Guangxi, in 1983 was followed, though the dosage of HD MTX was ( 1.5 ～ 2.0 ) g/m 2 each time instead of the recommended dosage. RESULTS: After 4 weeks of treatment, CR was obtained in all of the 44 patients. But to obtain CR, it took ( 3.83 ± 0.41 ) weeks in Group A and ( 3.00 ± 0.82 ) weeks in Group B (P< 0.05 ). To obtain CCR, it took ( 20.31 ± 16.71 ) months in Group A and ( 43.5 ± 25.56 ) months in Group B (P< 0.05 ). There was significant difference in the incidence of recurrence between Group A and Group B ( 66.7% vs 32.5% , P< 0.05 ). No significant difference was found between the two groups in the occurrence of complications during the chemotherapy. CONCLUSIONS: Patients of the intensified chemotherapy group not only obtained CR within a shorter period of time but also proved that the intensified chemotherapy is much better than the conventional therapy in both obtaining CCR and preventing the recurrence of ALL. The occurrence of complications resulting from chemotherapy could be prevented or reduced so long as appropriate measures are taken and close cooperations are provided by the parents of the patients. It is suggested that the intensified chemotherapy is more effective than the conventional one in childhood ALL.
