Treatment of primary refractory and relapsed acute lymphoblastic leukaemia in children and adults: the GIMEMA/AIEOP* experience
Article first published online: 12 MAR 2008
British Journal of Haematology
Volume 86, Issue 1, pages 55–61, January 1994
How to Cite
Giona, F., Testi, A. M., Annino, L., Amadori, S., Arcese, W., Camera, A., Di Montezemolo, L. C., Ladogana, S., Liso, V., Meloni, G., Moleti, M. L., Rondelli, R., Zanesco, L., Pession, A. and Mandelli, F. (1994), Treatment of primary refractory and relapsed acute lymphoblastic leukaemia in children and adults: the GIMEMA/AIEOP* experience. British Journal of Haematology, 86: 55–61. doi: 10.1111/j.1365-2141.1994.tb03252.x
- Issue published online: 12 MAR 2008
- Article first published online: 12 MAR 2008
- Received 30 April 1993; accepted for publication 20 August 1993
- advanced ALL;
- IDA, IDARA-C;
One hundred and forty-seven patients aged <55 years with advanced acute lymphoblastic leukaemia (ALL) were enrolled in an Italian cooperative study (ALL R-87), This protocol consists of an induction phase with idarubicin (IDA) plus intermediate-dose cytarabine (IDARA-C), followed by a consolidation phase and bone marrow transplant (BMT). Complete remission (CR) was achieved in 97/147 patients (66%) with a CR rate of 77% in children versus 51% in adults (P<0·01), 48 responders (50%) underwent BMT.
Probability of event-free survival (EFS ± SE) was 10·2±3·1% at 56 months. EFS was 14·3±4·51% at 56 months for children versus 3·8±3·41% at 37 months for adults (P<0·0001). Among patients treated in first relapse, EFS was 14·2±7·79% for patients with CR >18 months versus 6·6±3·17% for those with CR <18 months (P<0·0001).
Projected disease-free survival (DFS ±SE) was 15·4±4·61% at 55 months for all responders and 43·3±14·34% at 52 months for allografted patients. Projected overall probability of survival ±SE for all patients was 18·8±4·13% at 56 months.
This study confirms the efficacy of IDA plus IDARA-C in poor-risk ALL patients. A more intensive post-remission therapy or alternative approach must be designed to improve long-term results.