Abstract
The authors developed a new combination chemotherapy with epipodophyllotoxin, VM-26 or VP-16-213, and cytosine arabinoside (Ara-C) for childhood acute nonlymphocytic leukemia (ANLL). Ara-C was administered twice a day for 6 days at a dosage of 500 mg/m2 and epipodophyllotoxin was infused on days 1 and 4 at a dosage of 150 mg/m2. Four patients in relapse and 1 patient with initial induction failure were treated with this regimen. Three of 4 patients in relapse had been refractory to conventional therapy. Complete remission was achieved in 4 of 5 patients, all of whom were in relapse. The durations of remission were from 1 to over 17 months. Side effects included nausea and vomiting, fever, exanthema, and bome marrow suppression. However, none of these interrupted the continuation of therapy. This regimen is expected to be useful in the therapeutic strategy for refractory ANLL. We are now planning to make use of this regimen as initial induction therapy.
