Abstract
Three children with refractory acute lymphocytic leukemia received therapy with vincristine/ prednisolone/ l-asparaginase and recombinant human granulocyte colony-stimulating factor (G-CSF). One patient achieved complete remission and other patients achieved incomplete remission (5% or less blasts in bone marrow with abnormal peripheral and differential counts except a granulocyte count). Remission durations were short with a median of 40 days; the median survival was 137 days. One patient died of pulmonary fungal infection, but other deaths were due to relapsed leukemia. Side effects included infections, hypoalbuminemia, hypofibrinogenemia and hyperglycemia. In conclusion, the combination of vincristine/ prednisolone/ intensive l-asparaginase and recombinant human G-CSF had significant activity in children with refractory acute lymphocytic leukemia but the duration of remission was short. The addition of recombinant human hemopoietic growth factors to the intensive chemotherapy and the use of the combination regimen as part of front-line maintenance intensification therapy may further improve the prognosis in these patients.