Acute lymphoblastic leukaemia in adults in Sweden 1977-84: a retrospective analysis. Swedish ALL-Group

The present study is a retrospective analysis of the outcome in 210 patients diagnosed and treated as having acute lymphoblastic leukaemia (ALL) in Sweden during 1977-84. 131 patients were morphologically rediagnosed as ALL. For the ALL-patients, nine different remission induction regimens were used. Remission frequency was 69%, without statistical difference according to induction treatment. However, the reasons for remission failure differed among therapy groups. The number of responders was significantly higher among patients who received a remission induction therapy with an anthracycline and/or L-asparaginase. Maintenance therapy consisted in most cases of 6-mercaptopurine and methotrexate with reinduction courses for 2-3 years. Median survival time was 13 months and median duration of first remission (MRD) 11 months. For a subgroup of patients (n = 29) treated with the most intense remission induction regimens, including at least 4 cytostatic drugs with both an anthracyclilne and L-asparaginase, the MRD is not yet reached, the shortest follow up time is 43 + months, and the probability of remaining in complete remission is 66%. We conclude that aggressive cytostatic therapy, with induction regimens including both an anthracycline and L-asparaginase, may cure a considerable number of adult ALL-patients.