Fourteen adults with previously untreated acute lymphocytic leukemia (ALL) were treated initially with vincristine and prednisolone (VP) alone, and other agents including an anthracycline if the initial response was poor after about two weeks. Seven cases attained a complete remission (CR) with VP alone, and three of the other seven patients achieved CR after adding other agents, giving an overall CR rate of 71.4%. It seems possible to roughly estimate the possibility of inducing CR with VP alone from the degree of a decrease in the number of blasts in blood and bone marrow about two weeks after the start of VP therapy. At this time an increase in the counts of neutrophils and platelets was seen in some of the unresponders as well as the responders to the treatment with VP alone.
From our results and a review of the literature, we conclude that initial treatment with VP alone or plus L-asparaginase followed by an anthracycline is one of the excellent induction therapies for adult ALL, because this strategy can reduce the risk for life-threatening infection and bleeding during the intensive induction therapy.
