Vm‐26 with prednisone and vincristine for treatment of refractory acute lymphocytic leukemia

Gaston Rivera, W. Paul Bowman, Sharon B. Murphy, Gary V. Dahl, Rhomes J. Aur, David K. Kalwinsky, Adynel Wood, Shirley Stagner, Thomas L. Avery

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Fifty‐six children with refractory acute lymphocytic leukemia (ALL) were assessed for remission‐induction responses to VM‐26 (250 mg/m2 per week) in combination with prednisone (40 mg/m2 per day) and vincristine (1.5 mg/m2 per week). Each child had been treated intensively with steroids, vincristine, daunorubicin and L‐asparaginase. In fact, all patients had failed to respond to previous reinduction therapy with prednisone‐vincristine or had relapsed while receiving vincristine. Our intent in this study was to test whether or not addition of VM‐26 to prednisone‐vincristine would overcome clinical resistance to these established agents. Complete remissions were induced in 17 patients (0.30) over 4 to 6 weeks. Five of these children, all clinically unresponsive to prednisone‐vincristine alone, had complete remissions that lasted longer than 1 year; two remain in remission for 2 1/2 years and both are now off therapy. Myelosuppression, the most serious treatment complication, was documented in 20 of 26 evaluable patients. The median time to recovery of normal marrow function was 15 days. These results demonstrate further the potential of VM‐26 in combined‐drug treatment of refractory ALL. Whether the effectiveness of this combination represents potentiation of prednisone and vincristine activity by VM‐26 or some other, as yet unidentified interaction, remains to be determined.

Original languageEnglish
Pages (from-to)439-446
Number of pages8
JournalMedical and Pediatric Oncology
Volume10
Issue number5
DOIs
StatePublished - 1982

Keywords

  • VM‐26
  • childhood leukemia
  • combination chemotherapy
  • drug resistance
  • myelosuppression
  • prednisone
  • vincristine

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