Abstract
A total of 117 previously untreated children with acute leukemia (peroxidase negative) have been treated with cyclic intensive chemotherapy with or without intrathecal methotrexate (MTX) and hydrocortisone (HCS) injection between January 1969 and March 1978.
These protocols consist of 3 phases; Remission induction with vincristin and prednisolone, Intensive chemotherapy with “VAMP” regimen with or without prophylactic CNS-leukemia therapy with intrathecal MTX and HCS for 3 years and Maintenance with 6-mercaptopurine.
Of sixty-six patients who received prophylactic CNS-leukemia therapy with MTX 10-15mg/M2 only or plus HCS 15mg/M2 intrathecaly every 12 weeks, 22 patients (33.3%) had CNS-leukemia relapses 2.5-67 months after the start of CNS-leukemia therapy. Of fifty-one patients who received no prophylactic CNS-leukemia therapy, 28 patients (54.9%) had CNS-leukemia relapses.
In prophylactic CNS-leukemia therapy group, complete and hematological remission durations and survival were significantly prolonged than those in without prophylactic CNS-leukemia therapy group.
Toxicity of intrathecal MTX and HCS was observed in some patients who complained fever, nausea, vomiting and headache.
