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Salvage Therapy of Adult ALL

  • M. Freund
  • G. Heil
  • K. Pompe
  • R. Arnold
  • C. Bartram
  • Th. Büchner
  • H. Diedrich
  • C. Fonatsch
  • A. Ganser
  • W. Hiddemann
  • P. Koch
  • K. Kolbe
  • H. Link
  • H. Löffler
  • W. D. Ludwig
  • G. Maschmeyer
  • N. Schmitz
  • M. Schwonzen
  • E. Thiel
  • D. Hoelzer
  • German Relapsing Acute Lymphocytic Leukemia Study Group (GRALLSG)
Conference paper
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 37)

Abstract

In a first study (1986 to 1992) the German Relapsing ALL Study Group (GRALLSG) has treated 67 adult patients with a first relapse of ALL. A first phase of induction consisted of vindesine, daunorubicin, asparaginase, and prednisone, a second phase of high-dose cytosine-arabinoside (Hd ara-C) and VP16. Results: 45 CR, 2 PR, 13 failures, 7 early death. 25 patients received a BMT. 10 had an allogeneic BMT in CR, 5 after another relapse or with refractory disease. Of 10 with autologous BMT 8 have been in 2nd CR. Only 4 of all 67 patients are surviving without relapse: One after unrelated BMT (36+mo), two after autologous BMT in 2nd CR (46+, 64+mo), and one after chemotherapy (61+mo). One patient has been lost in relapse. The median survival is 7.2 months and the overall survival 4% after 5 years. The duration of the first CR was an important risk factor for response to induction. Patients are accordingly stratified in a new protocol. Patients with a preceding 1st CR<18 months receive Hd ara-C/idarubicin. The others are treated with the phase I of the previous protocol and a consolidation of Hd MTX, ifosfamide, prednisolone, ara-C and VP16. Furtheron a phase I/II trial is performed in patients with refractory disease or multiple relapses to evaluate the activity of 2-CDA.

Keywords

Acute Lymphocytic Leukemia Bone Marrow Transplantation Allogeneic Bone Marrow Transplantation Refractory Disease Autologous Bone Marrow Transplantation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • M. Freund
    • 1
  • G. Heil
    • 2
  • K. Pompe
    • 2
  • R. Arnold
    • 2
  • C. Bartram
    • 3
  • Th. Büchner
    • 4
  • H. Diedrich
    • 1
  • C. Fonatsch
    • 5
  • A. Ganser
    • 6
  • W. Hiddemann
    • 4
  • P. Koch
    • 4
  • K. Kolbe
    • 7
  • H. Link
    • 1
  • H. Löffler
    • 8
  • W. D. Ludwig
    • 9
  • G. Maschmeyer
    • 9
  • N. Schmitz
    • 8
  • M. Schwonzen
    • 10
  • E. Thiel
    • 11
  • D. Hoelzer
    • 6
  • German Relapsing Acute Lymphocytic Leukemia Study Group (GRALLSG)
  1. 1.Abteilung Hämatologie und OnkologieMedizinische Hochschule HannoverHannoverGermany
  2. 2.Medizinische Klinik und PoliklinikUniversität UlmUlmGermany
  3. 3.Sektion Molekularbiologie, Abteilung Kinderklinik IIUniversität UlmUlmGermany
  4. 4.Abteilung AMedizinische Universitätsklinik und PoliklinikMünsterGermany
  5. 5.Institut für Humangenetik, Arbeitsgruppe TumorzytogenetikMedizinische Universität LübeckLübeckGermany
  6. 6.Zentrum Innere Medizin, Abteilung HämatologieJohann-Wolfgang-Goethe-UniversitätFrankfurt am MainGermany
  7. 7.Abteilung für HämatologieJohannes-Gutenberg-UniversitätMainzGermany
  8. 8.II. Medizinische Universitäts- und PoliklinikKielGermany
  9. 9.Standort MDC — Robert Rössle Klinik, Hämatologie/Onkologie, Abteilung MolekularbiologieUniversitätsklinikum Rudolf Virchow der Freien UniversitätBerlinGermany
  10. 10.Medizinische UniversitätsklinikKölnGermany
  11. 11.Innere Medizin mit Schwerpunkt, Hämatologie und OnkologieUniversitätsklinikum SteglitzBerlinGermany

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