Abstract
To improve the remission rate of acute non-lymphatic leukemia, newer combinations of anti-leukemic agents were developed based on leukemic cell kinetics and pharmacological mechanisms. The combined treatment with Daunorubicin, Cytosine Arabinoside, Vincristine and Prednisolone; (DCVP) and initial treatment with Cytosine Arabinoside, and Vincristine followed by Daunorubicin and Prednisolone (New DCVP) were studied and compared with the standard DCMP program. Fifty-three cases of adult non-lymphatic leukemia were randomly divided into 3 groups, and were treated with DCMP, DCVP and New DCVP, resulting in complete remission rates of 42.9% (12/28), 90.0% (9/10) and 80.8% (12/15) respectively. Time required to obtain complete remission was 48 days with DCMP, 53 days with DCVP and 41 days with New DCVP; most patients did not require more than 2 courses of treatment. The DCVP and New DCVP groups had one death each versus 24 deaths in the DCMP group. The duration of remission and survival time of those which obtained remission were respectively 12 weeks and 15 months with DCMP, over 14 weeks and over 12 months with DCVP, and over 26 weeks and over 13 months with New DCVP. All 3 treatment programs caused serious bone marrow suppression; New DCVP produced the least suppression. Prominent side effects were impaired liver function with DCMP, and peripheral neuropathy with both DCVP and New DCVP. When considered with leukemic cell kinetics and pharmacological mechanisms of anti-leukemic agents, the above results indicate that New DCVP is the more rational and effective of the treatment programs studied.
