Acute lymphoblastic leukaemia in adults: results of a 'total-therapy' programme in 47 patients over 15 years old

For the last 13 years, 47 patients with ALL over 15 years old (range 15-72; median 21) entered a 'total-therapy' programme. All cases received a 6-8 week induction course of PRD, VCR, DRB and/or L-ASN. Prophylaxis of CNS was done by cranial radiotherapy plus i.t. MTX in 32/45 patients who attained complete remission (CR). After CR, subsequent therapy involved a programme of maintenance with 6MP and MTX at full doses. Pulses of intermittent reinforcement (PRD, VCR and DRB) were done for 2 weeks, every 3 months, for at least 3 years. CR was achieved in 42/47 patients (89.3%). The median relapse-free survival of the patients who attained CR was 57 months, with an 8-year estimated disease-free survival rate of 43% for those cases. If actuarial assumptions were to be sustained, it would indicate an encouraging cure rate of 38% of all our adult ALL patients (mainly in those cases between 15 and 30 years old).