Long-term survival of children with acute non-lymphoblastic leukemia

Results of a pilot protocol employing chemoimmunotherapy for treatment of 23 children with acute non-lymphoblastic leukemia consecutively diagnosed between 1975 and 1979 are reported. Twenty-two children achieved remission, ten of whom are surviving 6.5-9.5 years after completion of primary systemic therapy (median 7.8 years). Treatment consisted of intermittent courses of Daunomycin, Cytosine Arabinoside, 6-Thioguanine, VP-16, with or without Decadron, Connaught BCG applied between courses of chemotherapy for the first 8 months of treatment, and cranial irradiation/intrathecal Cytosine Arabinoside in early first remission. Five patients with leukemic cells in spinal fluid at diagnosis had myelomonoblastic or monoblastic subtypes and a median diagnostic white blood cell count (WBC) of 149,000/mm3 compared with a median WBC of 12,000/mm3 for the other 18 patients (P = .007).