Thirteen children with acute nonlymphocytic leukemia (ANLL) in first remission were treated with modified VAPA therapy including central nervous system (CNS) prophylaxis.
Twelve of 13 patients remain in continuous complete remission and 6 patients are in off therapy. A Kaplan-Meier analysis of patients predicts that 90.9% of patients will remain in remission at 2yr. Only one patient with FAB subtype M2 and high WBC count (182,500/cmm) had a bone marrow relapse.
Toxicities of this therapy consist of vomiting, marrow suppression and cardiotoxicity. However, with the intensive supportive care, patients were well tolerated.
We have concluded that modified VAPA therapy is very successful therapy for children with ANLL.
