[Present status of chemotherapy in ALL and CLL]

Present status of chemotherapy for acute lymphocytic leukemia (ALL) and chronic lymphocytic leukemia (CLL) was reviewed. In ALL, a 2-drug combination consisting of vincristine and prednisone (VP) obtained an overall complete remission rate of approximately 50% and when daunomycin or adriamycin was added to the regimen, the overall remission rate escalated to approximately 70%. Furthermore, L-asparaginase appeared to have a similar activity to the anthracyclines in combination with VP. Thus, VP plus one of these agents seemed to be a recommendable inductive chemotherapy against ALL. In CLL, remission rates obtained by the use of chlorambucil alone were ranged from 45 to 69%, while a 2-drug combination consisting of chlorambucil and prednisone obtained remission rates ranging 38 to 80%. Thus, the combination appeared to have superiority over chlorambucil alone. When this first line chemotherapy fails to obtain remissions, a 3-drug combination consisting of cyclophosphamide, vincristine and prednisone is worthwhile to try as a second line treatment.