mercaptopurine and Remission--Spontaneous

Topics: Asparaginase; Child; Cyclophosphamide; Germany, West; Humans; Injections, Spinal; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

Pure red cell aplasia is a selective aplasia of the marrow erythroid cells. Unlike aplastic anemia, the marrow has a normal cellularity and the patients generally have normal leukocyte and platelet blood counts. The congenital form of the disease occurs in the firlst 1 1/2 years of life and is often responsive to corticosteroids. The acquired form may be secondary to infections, drugs, chemicals, or hemolytic anemia (aplastic crisis). In these cases it is often acute and self-limited with cessation of the infection or drug ingestion. It may also be secondary to systemic lupus erythematosus, rheumatoid arthritis, acute severe renal failure, severe nutritional deficiency, or diverse neoplasms, and may remit with treatment of the primary condition. When a thymoma is present, it should be resected since a remission is produced in 29 per cent of these patients. The remaining patients have an acquired primary form of the disease that tends to be chronic and in some cases may have an immune pathogenesis. A cytotoxic immunoglobulin inhibitor of the marrow erythroid cells or erythropoietin has been described and these patients may respond to prednisone and/or to cytotoxic immunosuppressive drugs such as cyclophosphamide and 6-mercaptopurine. Pure red cell aplasia appears to be more common than the literature has revealed and has stimulated much investigation into an immune pathogenesis for marrow failure.

Topics: Acute Kidney Injury; Anemia, Aplastic; Antilymphocyte Serum; Arthritis, Rheumatoid; Blood Cell Count; Blood Transfusion; Cyclophosphamide; Deficiency Diseases; Erythropoietin; Humans; Immune System Diseases; Infections; Lupus Erythematosus, Systemic; Mercaptopurine; Prednisone; Remission, Spontaneous; Splenectomy; Thymoma; Thymus Neoplasms

The autoimmune nature of idiopathic thrombocytopenic purpura, as currently defined, is well established. Manipulations of the immune apparatus aimed at abating this deviant immunologic state may be one mode of approach to the therapy of this disease. Several cytotoxic compounds are capable of inhibiting the primary and secondary immune response to experimentally injected antigens in animals and man. Their beneficial role in the treatment of an autoimmune lupus-like syndrome in NZB mice24 is well documented. In human autoimmune disease, efficacy of the drugs is still to be established. The mechanisms by which immunosuppressive agents effect therapeutic response, and, in particular, whether this action is linked to suppression of immune reactivity needs clarification. Although preliminary analysis of the efficacy of immunosuppressive drugs in idiopathic thrombocytopenic purpura is encouraging, their therapeutic role has not superseded that of conventional management with steroids and splenectomy. Carefully controlled randomized clinical trials are now necessary so that more rational use of these agents can be recommended in future reports.

Topics: Azathioprine; Cyclophosphamide; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Mercaptopurine; Purpura, Thrombocytopenic; Remission, Spontaneous; Splenectomy; Vinblastine; Vincristine

Current therapy has resulted in improved prognosis in previously untreated children with acute lymphocytic leukemia less than 16 years of age. The induction phase of chemotherapy should include the use of at least prednisone and vincristine. This combination should result in a hematologic remission in about 90 per cent of the patients. The efficacy of the addition of either L-asparaginase or daunomycin, the consolidation phase or the periodic readministration of induction drugs has not been established. Specific central nervous system treatment, early in the course of therapy, is an integral component of recently reported effective protocols. Several modalities of prophalytic central nervous system therapy have been utilized. These include cranial irradiation plus intrathecal methotrexate, craniospinal irradiation and intrathecal methotrexate alone. An encephalopathy syndrome has been reported as a complication in 10 to 66 per cent of these patients. The most effective form of central nervous system therapy, associated with the least toxicity, has not been established. Maintenance chemotherapy should include a combination of two or more drugs. Complications are numerous, and include hematopoietic depression, immunosuppression, overwhelming infections, and, possibly, the development of secondary primary cancers. In the most successful protocols maintenance chemotherapy has been administered for 3 years. Because of the potential significant toxicity there is a need to define the optimal duration of maintenance therapy. Psychological complications developing in a patient with a disease now considered a potential long term chronic illness, rather than a disease once considered universally fatal, are also discussed. The possibility of an immunologic deficiency allowing for the initial development of acute lymphocytic leukemia and the role of immunotherapy are presented. While the use of intensive combination chemotherapy and specific central nervous system prophylactic therapy have resulted in an improved prognosis in childhood acute lymphocytic leukemia, because of a significant incidence of failures, a standardized single form of therapy has not been established.

Topics: Asparaginase; Central Nervous System Diseases; Child; Cyclophosphamide; Daunorubicin; Drug Therapy, Combination; Humans; Immunotherapy; Infections; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Neoplasms, Multiple Primary; Prednisone; Psychology; Remission, Spontaneous; Vincristine

The authors review and discuss the basic concepts of cell kinetics as applied to brain tumors. Uncontrolled growth of a neoplasm represents an expanding tumor cell population. Four growth parameters characterize the behavior of a neoplastic population: cell cycle time, growth fraction, tumor doubling time, and cell loss. The concept of provisionally nondividing cells explains the disparity between cell cycle time and tumor doubling time. Human gliomas, like many non-neural solid tumors, contain variable proportions of actively proliferating and nonproliferating tumor cells; this ratio is expressed by the growth fraction. The major kinetic difference between glioblastomas and differentiated astrocytomas resides in their respective growth fractions, in all likelihood an inherent biological characteristic of each tumor. Glioblastoma proliferates at a rapid rate, and only a high rate of cell loss prevents this tumor from doubling its volume in less than 1 week. The selection of drugs and design of drug schedules for treatment of glioblastomas should be made with the knowledge that 60% to 70% of the cells in this tumor are resting (nonproliferating). If experience with other solid tumors is any guide, judicious selection and combined use of drugs according to kinetically sound schedules will produce more effective chemotherapy of brain tumors.

Topics: Alkylating Agents; Anti-Bacterial Agents; Antimetabolites; Astrocytoma; Brain; Brain Neoplasms; Cell Survival; DNA, Neoplasm; Glioma; Humans; Kinetics; Mercaptopurine; Mitosis; Neoplasm Metastasis; Prednisolone; Remission, Spontaneous; RNA, Neoplasm; Time Factors; Vincristine

Topics: Acute Disease; Adolescent; Adult; Aged; Antineoplastic Agents; Child; Child, Preschool; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

Topics: Asparaginase; Child; Cyclophosphamide; Cytarabine; Daunorubicin; Doxorubicin; Humans; Leukemia, Lymphoid; Male; Meninges; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Prednisolone; Remission, Spontaneous; Testicular Neoplasms; Time Factors; Vincristine

Topics: Acute Disease; Adrenal Cortex Hormones; Antineoplastic Agents; Drug Therapy, Combination; Humans; Immunosuppressive Agents; Infection Control; Injections, Intramuscular; Injections, Intravenous; Leukemia; Mercaptopurine; Methods; Methotrexate; Mitosis; Prednisolone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adult; Burkitt Lymphoma; Child; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Combinations; Hodgkin Disease; Humans; Immunotherapy; Infections; Leukemia, Lymphoid; Leukemia, Myeloid; Lymphoma; Mercaptopurine; Methotrexate; Middle Aged; Nitrogen Mustard Compounds; Prednisone; Procarbazine; Prognosis; Remission, Spontaneous; Vincristine

Topics: Acute Disease; Adult; Age Factors; Antineoplastic Agents; Asparaginase; Child; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methods; Methotrexate; Prednisolone; Recurrence; Remission, Spontaneous; Vincristine

Topics: Acute Disease; Antineoplastic Agents; Chlorambucil; Chlorine; Chronic Disease; Daunorubicin; Dimethoate; Drug Therapy, Combination; Ethylamines; Glucocorticoids; Humans; Immunoglobulins; Immunosuppression Therapy; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Leukocyte Count; Lymphocytosis; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous

Topics: Acute Disease; Adult; Aged; Antineoplastic Agents; Blood Coagulation Disorders; Cell Transformation, Neoplastic; Daunorubicin; Humans; Immunotherapy; Leukemia; Leukemia, Lymphoid; Mercaptopurine; Middle Aged; Mitosis; Prednisolone; Prednisone; Remission, Spontaneous; Vincristine

Topics: Asparaginase; Blood Transfusion; Cytarabine; Daunorubicin; Humans; Immunotherapy; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Leukocytes; Meninges; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Animals; Antineoplastic Agents; Asparaginase; Central Nervous System Diseases; Child; Cyclophosphamide; Cytarabine; Cytopathogenic Effect, Viral; Daunorubicin; Humans; Kinetics; Leukemia, Experimental; Leukemia, Lymphoid; Meninges; Mercaptopurine; Methotrexate; Mice; Oncogenic Viruses; Patient Care Team; Remission, Spontaneous; Reverse Transcriptase Inhibitors; RNA Viruses; RNA-Directed DNA Polymerase; Time Factors; Vincristine

Topics: Asparaginase; Bacterial Infections; Central Nervous System Diseases; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Synergism; Hemorrhage; Humans; Immunotherapy; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Mitosis; Neoplasms, Nerve Tissue; Prednisone; Remission, Spontaneous; Testicular Neoplasms; Uric Acid; Vincristine

Topics: Adult; Agranulocytosis; Animals; Azathioprine; Child; Cyclophosphamide; Fertility; Glomerulonephritis; Humans; Leukopenia; Mercaptopurine; Mice; Nephrotic Syndrome; Prednisolone; Rats; Remission, Spontaneous

Topics: Child; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Synergism; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Meningitis; Mercaptopurine; Prednisone; Remission, Spontaneous; Thioguanine; Vincristine

Topics: Acute Disease; Age Factors; Child; Diagnostic Errors; Drug Synergism; Family Practice; Follow-Up Studies; Humans; Leukemia; Mercaptopurine; Methotrexate; Referral and Consultation; Remission, Spontaneous; Time Factors

Topics: Animals; Antibiotics, Antineoplastic; Antineoplastic Agents; Asparaginase; Azaserine; Cell Division; Clinical Trials as Topic; Cyclophosphamide; Cytarabine; Disease Models, Animal; Drug Combinations; Humans; Kinetics; Leukemia L1210; Leukemia, Experimental; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Neoplasms; Prednisone; Remission, Spontaneous; RNA, Neoplasm; Vincristine

Topics: Adult; Antineoplastic Agents; Asparaginase; Carmustine; Child; Cyclophosphamide; Cytarabine; Cytosine; Daunorubicin; Drug Therapy, Combination; Hodgkin Disease; Humans; Immunotherapy; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Lymphoma; Male; Mechlorethamine; Mercaptopurine; Methotrexate; Nitrogen Mustard Compounds; Prednisolone; Prednisone; Procarbazine; Remission, Spontaneous; Vincristine

Topics: Adrenal Cortex Hormones; Adult; Azathioprine; Clinical Trials as Topic; Crohn Disease; Double-Blind Method; Drug Therapy, Combination; Humans; Mercaptopurine; Pancreatitis; Placebos; Prednisone; Random Allocation; Remission, Spontaneous; Sulfasalazine; Time Factors

In this study 523 previously untreated patients with acute myelocytic leukemia were randomly allocated to induction therapy with daunorubicin 60 mg/M2 daily X 3, cytosine arabinoside and thioguanine 100 mg/M2 each every 12 hours until marrow hypoplasia was achieved, or a 5-day course of the three drugs with daunorubicin 100 mg/M2 given on dav 1 and cytosine arabinoside plus thioguanine each given at a dose of 100 mg/M2 every 12 hours for five days. All patients received cyclophosphamide 600 mg/M2 followed in 24 hours by hydroxyurea 500 mg/M2 every six hours for four doses monthly for maintenance therapy. Patients were randomized to receive one of three antimetabolite treatments beginning 24 hours after the last dose of hydroxyurea each month for seven days. One such treatment consisted of 6-mercaptopurine 100 mg/M2 daily, another group received 6-thioguanine at the same dose daily, and the third group received 50 mg/M2 of both antimetabolites daily. There were no significant differences in complete response rate, remission duration, or survival among the various treatment groups.

Topics: Adult; Age Factors; Aged; Antineoplastic Agents; Bone Marrow; Clinical Trials as Topic; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Administration Schedule; Drug Synergism; Drug Therapy, Combination; Female; Humans; Hydroxyurea; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Remission, Spontaneous; Thioguanine

L-Asparaginase, in the dose of greater than or equal to 6000 IU/sq m three times weekly, was demonstrated to be an effective agent in reinduction of remissions in childhood leukemia. Four hundred thirteen children with acute lymphocytic leukemia were treated with L-asparaginase. Doses i.m. ranged from 300 to 12,000 IU/sq m. None of the patients had received prior asparaginase therapy. 6-Mercaptopurine was given p.o. concurrently. All of the patients had experienced several previous relapses, and their disease was not responsive to 6-mercaptopurine. L-Asparaginase was found to be effective in reinducing remissions at the following rates: 9.5% for 300 IU/sq m; 35.1% for 3,000 IU/sq m; 53.5% for 6,000 IU/sq m; and 62.5% for 12,000 IU/sq m. The drug was given three times weekly for four weeks. Hypersensitivity reactions occurred in 6.5% of patients.

Topics: Asparaginase; Child; Child, Preschool; Clinical Trials as Topic; Drug Administration Schedule; Drug Hypersensitivity; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Mercaptopurine; Neutropenia; Remission, Spontaneous

This cooperative prospective study was designed to answer the following questions in cases with acute lymphoblastic leukemia induced to achieve complete remission with the combination of vincristine and prednisone (if by day 29 the bone marrow was not M1, daunorubicin was added to the former regimen) and who received preventive CNS therapy with 2400 rad of cobalt-60 to craniocervical region and simultaneously intrathecal methotrexate and dexamethasone: 1) Is a short intensification with cytosine-arabinoside and cyclophosphamide immediately after complete remission useful? 2) Does the use of weekly doses of 6-mercaptopurine and methotrexate have the same maintenance effect as daily 6-mercaptopurine and twice weekly methotrexate? and 3) Do further 3 month-doses of intrathecal methotrexate and dexamethasone help to decrease still more the incidence of meningeal leukemia? From October 1972 to December 1975, 473 previously untreated patients entered this study and 465 (390 children and 75 adults) are evaluated in this paper. Of them, 373 (80%) achieved complete remission (children 84% and adults 61%). Out of 109 "high risk" children (one or more of the following characteristics at diagnosis: marked organomegaly, mediastinal widening, leukocytosis above 50000/mm3 and CNS involvement) 83 (76%) and out of 281 "standard risk" children (all the others) 244 (87%) achieved complete remission. The median duration of complete remission according to different prognostic factors was as follows: "high risk" children 10 months, adults 24 months and "standard risk" children 25 months. Duration of complete remission of the "standard risk" children in relation to with or without intensification, daily or weekly maintenance and additional intrathecal therapy or none, showed no significant difference; however, those who received intensification, daily maintenance and further intrathecal therapy behaved slightly better. Median survival for all the cases of this study was as follows: adults 10 months, "high risk" children 12 months and "standard risk" children 26 months. At 36 months, 13% of "high risk" children, 25% of adults and 39% of "standard risk" children are still alive. We conclude that the variables studied in this protocol did not show significant extension of complete remission, however the sum of them seems to offer some advantage. Moreover, what appears clear is the importance of prognostic factors which must be taken into account in future studies.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Central Nervous System Diseases; Child; Cyclophosphamide; Cytarabine; Daunorubicin; Dexamethasone; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Prognosis; Radiotherapy, High-Energy; Remission, Spontaneous; Risk; Time Factors; Vincristine

Thirteen adults with acute lymphoblastic leukemia were entered into a protocol in which cytosine arabinoside infusion was added to vincristine and prednisone as remission induction and periodic intensification therapy. Central nervous system prophylaxis consisting of cranial irradiation and intrathecal methotrexate was given, and all patients received continuous oral 6-mercaptopurine and methotrexate as maintenance treatment. Myelotoxicity was severe during induction, with prolonged granulocyte and platelet count nadirs noted. Nine of 13 patients (69%) obtained a complete remission and one (8%) obtained a partial remission. The median duration of complete remission was 38.1 weeks. It was concluded that cytosine arabinoside in combination with vincristine and prednisone is an effective but toxic antileukemic regimen which did not produce a major improvement in remission duration.

Topics: Adult; Aged; Central Nervous System Diseases; Clinical Trials as Topic; Cytarabine; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Middle Aged; Prednisone; Remission, Spontaneous; Vincristine

The urinary excretion of 4-aminimidazole-5-carboxamide (AIC) as been reported to be increased in children with acute leukemia and has been correlated with disease status. Using a modification of the method of Skibba et al [5], determinations were made on urine from 26 children with acute leukemia. The urine from ten normal children served as controls. The effect of chemotherapy on urinary AIC was studied comparing patients on vincristine and prednisone (V+P) with those on 6-mercaptopurine, methotrexate, and cyclophosphamide (Triple Rx). Patients in remission on Triple Rx had lower levels of urinary AIC than did patients on Triple Rx in relapse or patients on V+P in either remission or relapse. Twenty patients had sequential measurements. Values for individual patients were not predictive of disease status. One such patient is described. This study demonstrates that chemotherapy, as well as disease status, affects the urinary excretion of AIC in children with acute leukemia.

Topics: Acute Disease; Adolescent; Aminoimidazole Carboxamide; Antineoplastic Agents; Child; Child, Preschool; Clinical Trials as Topic; Cyclophosphamide; Drug Therapy, Combination; Female; Humans; Imidazoles; Infant; Leukemia; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

Sixteen patients in an acute blast crisis of chronic myeloid leukaemia (CML) were treated with a combination of vincristine, 6-mercaptopurine, hydroxyurea and prednisone. Only two of these patients had complete remission on this treatment, while four had partial remission. This experience, comparable to that reported by others, suggests that aggressive treatment in the terminal phase of CML is justified only as part of a prospective and well-controlled study.

Topics: Adolescent; Adult; Aged; Drug Therapy, Combination; Female; Humans; Hydroxyurea; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisone; Prospective Studies; Remission, Spontaneous; Switzerland; Vincristine

This study was designed to determine if resistance to a standard drug during the second remission of children with acute leukemia was reduced by discontinuation of therapy during the initial remission. The initial maintenance therapy was either 6-mercaptopurine (6-MP), methotrexate (MTX), or cyclophosphamide (CYC) given continuously to relapse or discontinued (at random) at 2 or 6 months. Following the initial relapse and after induction of a second complete remission, 72 evaluable patients received (continuously to relapse) either 6-MP (53 patients) or CYC (19 patients) for the second remission maintenance. Resistance of 6-MP occurred during the second maintenance, regardless of the drug used during the initial maintenance, in that the length of second remissions was significantly shorter than the length of first remissions. However, this resistance was most pronounced in patients who initially relapsed while on continuous 6-MP maintenance (medium duration of remission [MDR] of 9 weeks). Patients whose initial relapse occurred after the discontinuation of 6-MP had a MDR of 23 weeks and patients whose second remission was maintained with CYC (after relapse from initial continuous remission on 6-MP) had a MDR of 25 weeks.

Topics: Acute Disease; Antineoplastic Agents; Child; Clinical Trials as Topic; Cyclophosphamide; Drug Resistance; Follow-Up Studies; Humans; Leukemia; Mercaptopurine; Methotrexate; Neoplasm Recurrence, Local; Remission, Spontaneous

Topics: Adolescent; Antineoplastic Agents; Asparaginase; BCG Vaccine; Child; Child, Preschool; Clinical Trials as Topic; Cyclophosphamide; Humans; Immunotherapy; Infant; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

The results of treatment in a group of 50 children with acute lymphatic leukemia are summarized. A comparison was made between those who received prophylactic central nervous systen (CNS) therapy on attaining complete remission and those who did not. Although none of the prophylactically treated children developed CNS leukemia, the expected prolongation of median complete remission time was not achieved. It was found that there was a high percentage of poor-risk patients in the CNS-treated group, and these patients relapsed early in the course of the disease. The prevention of CNS leukemia, a late complication of the disease, did not change the natural course of the disease in poor-risk patients. A need exists for new treatment protocols aimed at better control of the disease in these poor-risk cases.

Topics: Adolescent; Central Nervous System Diseases; Child; Child, Preschool; Clinical Trials as Topic; Drug Therapy, Combination; Humans; Infant; Leukemia, Lymphoid; Mercaptopurine; Prednisone; Remission, Spontaneous; Risk; Time Factors

Of 41 adults with a diagnosis of acute leukemia that were randomized for induction therapy in combination with methotrexate, 6-MP, vincristine and prednisone (POMP) versus a combination of cytosine arabinoside, cytoxan, vincristine and prednisone (COAP), 23 (56%) patients achieved a complete remission. During remission, patients received consolidation therapy with the three courses of remission induction regimen that they had not received initially. They then received daunomycin (three courses) and L-asparaginase and were then maintained for two years with their induction therapy. The median duration of survival for all patients was 40 weeks; the median duration of survival of those patients that responded to chemotherapy was 80 weeks. There was no significant difference between the two induction regimens with regard to complete remission more than four and one half years from diagnosis and two and one half years from discontinuation of all therapy.

Topics: Acute Disease; Adolescent; Adult; Aged; Antineoplastic Agents; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Drug Administration Schedule; Female; Humans; Infant; Infant, Newborn; Leukemia; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Vincristine

Twenty-four children (2 to 21 years) diagnosed as having AML from 1969 to 1972 were randomized to receive either a single combination (COMP or PRAVD) or sequential combination chemotherapy (alternating POMP and PRAVD). Seventeen achieved complete remission. Patients who received POMP alone had the longest median duration of remission (1,400 days) compared to PRAVD (395 days) or POMP-PRAVD (270 days); interpretation of this difference is uncertain, since the numbers in each group are small. Fifteen patients have relapsed, four initially with CNS involvement. Successful reinduction was achieved almost exclusively for patients who had initially received POMP. Survival after first relapse was short. Patients less than 16 years had a median survival of 632 days, compared to 285 days for patiens greater than 16 (p less than 0.05). The high initial induction rate in these patients is encouraging, but the duration remission is inferior to that seen in childhood ALL. Moreover, the slope of the relapse curve is continuous over a five-year period with no definite plateau where it might appear that patients are no longer at risk of relapse. Improved methods for the treatment of childhood ALL and adult AML suggest possible new approaches to AML in children, with prophylactic treatment of central nervous system, late intensification, and immunotherapy.

Topics: Adolescent; Antineoplastic Agents; Child; Child, Preschool; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Vincristine

The first and second Medical Research Council UKALL trials have shown that alteration in the timing of methotrexate and 6-mercaptopurine maintenance therapy for the treatment of acute lymphoblastic leukaemia can markedly change drug induced toxicity. Maintenance chemotherapy in both trials used a similar total dosage of these drugs but the timing of their administration was different in the two schedules.

Topics: Child; Child, Preschool; Drug Therapy, Combination; Humans; Infant; Infant, Newborn; Leukemia, Lymphoid; Leukocyte Count; Lymphocytes; Lymphopenia; Mercaptopurine; Methotrexate; Neutropenia; Neutrophils; Remission, Spontaneous; Time Factors

Topics: Acute Disease; Age Factors; Animals; Antineoplastic Agents; Asparaginase; Central Nervous System Diseases; Child; Child, Preschool; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Infant; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

To evaluate responses to medical therapy in ulcerative colitis, rectal biopsies of patients with active untreated disease, individuals with positive and negative sigmoidoscopic findings treated with salicylazosulfapyridine, prednisone and 6-mercaptopurine, alone and in combinations and noncolitis controls were compared histologically. Predominant histological observations were analyzed statistically. There were fewer crypt abscesses but more mucosal edema after all forms of therapy. Quantitative histopathological analysis failed to demonstrate that the response to one drug was significantly different from another.

Topics: Biopsy; Clinical Trials as Topic; Colitis, Ulcerative; Drug Evaluation; Drug Therapy, Combination; Humans; Intestinal Mucosa; Mercaptopurine; Prednisone; Rectum; Remission, Spontaneous; Sigmoidoscopy; Sulfasalazine

The progressive improvement in the prognosis of acute lymphocytic leukemia has been a result of two major developments: 1) the more efficient use of chemotherapeutic agents, particularly the use of combinations of agents and the discovery that agents effective at one stage of disease may be inappropriate at another stage, and 2) the prevention with irradiation of central nervous system relapse. As many as one-half of children with this disease may enjoy long-term leukemia-free survival. However, further studies are needed to improve the efficacy and reduce the toxicity of therapy. This paper reviews the evolution of some of these studies.

Topics: Age Factors; Antineoplastic Agents; Asparaginase; Brain Neoplasms; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Radiotherapy; Remission, Spontaneous; Spinal Cord Neoplasms; Vincristine

Three hundred twenty-six patients with acute myelocytic leukemia were randomly and prospectively assigned to four therapeutic regimens: cytosine arabinoside either alone or in combination with daunorubicin, 6-mercaptopurine, or 6-thioguanine. The results in 231 qualified previously untreated patients were analyzed. The combination treatments produced a significantly greater frequency of complete or partial remission than single drug therapy. Treatment with cytosine arabinoside and thioguanine led to 48% age-adjusted complete and partial responses. The median sur survival from diagnosis of all 66 evaluable patients treated with these two drugs was 18 weeks, while the median survival for those who responded to this combination was 15 months.

Topics: Adult; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Remission, Spontaneous; Thioguanine; Time Factors

The degree of drug-induced neutropenia resulting from a controlled trial (UKALL I) of treatment in acute lymphoblastic leukaemia was analysed. The main agent associated with severe neutropenia was methotrexate, and methotrexate-induced neutropenia was significantly greater in patients who had received craniospinal irradiation. The synergistic toxic effect of irradiation followed by methotrexate treatment seems to have contributed to three of the five deaths which occurred in complete remission in this trial; all deaths in remission occurred in patients who had received central nervous system prophylaxis. Analysis of patients who subsequently relapsed compared with those still in remission after 18 months of treatment indicated that the former, on average, had slightly lower neutrophil counts. This suggests that the children who relapsed did not receive any less aggressive treatment than those who remained in remission.

Topics: Agranulocytosis; Central Nervous System; Child; Child, Preschool; Clinical Trials as Topic; Cytarabine; Dose-Response Relationship, Drug; Drug Therapy, Combination; Humans; Injections, Spinal; Leukemia, Lymphoid; Lymphocytes; Mercaptopurine; Methotrexate; Neutropenia; Prednisolone; Radiation Effects; Radiotherapy Dosage; Remission, Spontaneous; Time Factors; Vincristine

Remission induction therapy with 6MP and adriamycin in combination was administered to 19 adult leukemic patients refractory to previous therapy. Eight patients also received vincristine and prednisone. Thirteen patients had acute myelogenous leukemia, 3 undifferentiated leukemia, and 3 blastic transformation of chronic myelogenous leukemia. Four patients achieved remission but in only 2 were the remissions complete. Eleven patients failed to respond. Ten of the 19 patients developed unexpected severe liver toxicity manifested by a clinical picture of cholestasis (in the majority) or ascending cholangitis (in 2 patients). In the postmortem examination of 8 patients there was cholestasis and mild to severe hepatocellular damage in all.

Topics: Acute Disease; Adult; Blood Cell Count; Clinical Trials as Topic; Doxorubicin; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Leukemia; Male; Mercaptopurine; Remission, Spontaneous; Time Factors

In 67 patients with acute leukemia 76 treatment-series were performed which were analyzed to evaluate whether chemotherapy has brought some progress during the past years. With 67 sufficient treatments a total of 26 remissions were achieved. VIDaP-scheme with 43 p.c. and cytosinarabinosid with 46 p.c. were significantly superior to the older scheme methotrexat-purinethol-prednisone with only 29 p.c. remissions. A remarkable deterioration of prognosis with increasing age rises the question whether treatment with cytotoxic drugs should be tried in patients more than 60 years old. Remission rate in patients below 20 was especially high with 71 p.c. so that the well-known good prognosis of juvenile leukemia can be extended with some limitations until age 20.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Aminosalicylic Acids; Antineoplastic Agents; Cytarabine; Drug Combinations; Esterases; Histocytochemistry; Humans; Leukemia; Mercaptopurine; Methotrexate; Middle Aged; Peroxidases; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

The three treatment regimens evaluated in this study (vinblastine alone versus prednisone and vinblastine versus prednisone and 6-mercaptopurine) proved to be about equally efficacious in children with histiocytosis x. Inasmuch as many physicians regard this disorder as one with a high mortality rate, it is worth emphasizing that 59 of the 83 patients (71% are living).

Topics: Adolescent; Age Factors; Child; Child, Preschool; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Infant; Infant, Newborn; Lymphatic Diseases; Male; Mercaptopurine; Prednisone; Remission, Spontaneous; Vinblastine

A total of 180 children with acute leukemia was randomized to one of two induction regimens: vincristine plus prednisone, or 6-mercaptopurine plus prednisone. Of 170 patients evaluable for induction therapy, a hematologic remission was achieved in 83% (72/87) on vincristine plus prednisone, and in 93% (77/83) on 6-mercaptopurine plus prednisone. When hematologic remission was achieved, patients were randomized to one of three maintenance schedules: 6-mercaptopurine alone, 6-mercaptopurine plus prednisone for 4 weeks every 3 months, or 6-mercaptopurine plus prednisone plus vincristine for 4 weeks every 3 months. The durations of hematologic remission were compared from the achievement of hematologic remission to bone marrow relapse. The survival data were presented as an overview of the effect of this initial therapy on duration of survival. There was no statistical difference between the two induction regimens. The most important finding in the comparison of the three maintenance schedules was that reinforcement of 6-mercaptopurine maintenance therapy with either prednisone or prednisone plus vincristine resulted in significantly longer durations of remission. Vincristine added to prednisone for reinforcement after induction of remission by vincristine plus prednisone did not increase the duration of hematologic remission or survival over prednisone reinforcement alone.

Topics: Acute Disease; Adolescent; Child; Drug Therapy, Combination; Humans; Leukemia; Mercaptopurine; Prednisone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adolescent; Adult; Alanine Transaminase; Blood Cell Count; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Middle Aged; Prednisolone; Remission, Spontaneous; Ribonucleosides; Time Factors

Topics: Adolescent; Adult; Age Factors; Aged; Asparaginase; Blood Platelets; Child; Clinical Trials as Topic; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid, Acute; Leukocyte Count; Lymphocytes; Male; Mercaptopurine; Middle Aged; Prednisone; Prognosis; Remission, Spontaneous; Thioguanine; Thrombocytopenia

Consecutive adult patients admitted to St. Bartholomew's Hospital with acute myelogenous leukaemia have been treated with a remission induction drug schedule consisting of daunorubicin and cytosine arabinoside. Intermittent five-day courses were used in 72 patients, and a complete remission was obtained in 39 patients (54%). An alternative drug schedule in 22 patients resulted in fewer remissions but this may have been due to age differences in the two groups. Age and initial platelet count were found to be important factors in determining the success of remission induction therapy; the older patients and those with low platelet counts responded less well.A series of 23 patients who achieved remissions was divided into two groups; one received intermittent combination chemotherapy as the only form of maintenance, and the other was given weekly immunotherapy in addition to the chemotherapy. The immunotherapy consisted of irradiated allogeneic leukaemic cells and B.C.G. Eight of the 10 patients on chemotherapy alone have already relapsed compared with five out of 13 patients in the immunotherapy group. It is hoped that these promising initial results with this form of maintenance will be confirmed as more patients enter the maintenance trials.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Antineoplastic Agents; BCG Vaccine; Blood Cell Count; Blood Platelets; Child; Cytarabine; Daunorubicin; Humans; Immunotherapy; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Middle Aged; Remission, Spontaneous; Thioguanine

Topics: Adolescent; Adult; Blood Transfusion, Autologous; Brain Neoplasms; Child; Child, Preschool; Cobalt Isotopes; Cyclophosphamide; Female; Humans; Infant; Infections; Injections, Intravenous; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Radiation Dosage; Radiation Effects; Remission, Spontaneous; Spinal Cord Neoplasms; Time Factors

Topics: Adolescent; Adult; Antineoplastic Agents; Asparaginase; Carmustine; Cell Division; Cell Transformation, Neoplastic; Child; Child, Preschool; Daunorubicin; Humans; Infant; Infant, Newborn; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Mitosis; Prednisone; Remission, Spontaneous; Vincristine

Topics: Adolescent; Anemia, Aplastic; Bone Marrow; Bone Marrow Cells; Child; Child, Preschool; Clinical Trials as Topic; Digestive System; Drug Combinations; Female; Humans; Leukemia, Myeloid, Acute; Leukopenia; Male; Mercaptopurine; Remission, Spontaneous; Triazines; Vincristine

Topics: Acute Disease; Adult; Antineoplastic Agents; Clinical Trials as Topic; Daunorubicin; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Prospective Studies; Remission, Spontaneous; Time Factors; Vincristine

One hundred and ninety-one cases of acute lymphoblastic leukaemia were entered in a trial in which, for five months, all received cytotoxic therapy with prednisolone, vincristine, mercaptopurine, L-asparaginase, and methotrexate (the latter in high dosage followed by folinic acid). Patients were then randomized to receive immunotherapy (B.C.G.), twice-weekly methotrexate, or no further treatment.One hundred and seventy-seven patients (93%) achieved full remission and at the time of analysis, 26 months from the beginning of the trial, 143 were still alive, including 70 in their first remission. Median "post-intensive" remission lengths were 17 weeks (no treatment), 27 weeks (B.C.G.), and 52 weeks (methotrexate). The prolongation of remission by methotrexate was most evident in those patients with low initial white cell counts. B.C.G. seemed to cause lymphocytosis but was without other conspicuous effect. The incidence of toxic reactions is reported, including an unusually low rate of anaphylaxis with L-asparaginase.These preliminary results are discussed and compared with those of similar trials.

Topics: Acute Disease; Adolescent; Adult; Anaphylaxis; Asparaginase; BCG Vaccine; Child; Child, Preschool; Clinical Trials as Topic; Humans; Infant; Leucovorin; Leukemia, Lymphoid; Leukocyte Count; Lymphocytes; Lymphocytosis; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Skin Tests; Tuberculin Test; Vincristine

Topics: Animals; Antibiotics, Antineoplastic; Antineoplastic Agents; Asparaginase; Azaserine; Cell Division; Clinical Trials as Topic; Cyclophosphamide; Cytarabine; Disease Models, Animal; Drug Combinations; Humans; Kinetics; Leukemia L1210; Leukemia, Experimental; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Neoplasms; Prednisone; Remission, Spontaneous; RNA, Neoplasm; Vincristine

Topics: Adult; Antineoplastic Agents; Asparaginase; Child; Clinical Trials as Topic; Cyclophosphamide; Cytarabine; Daunorubicin; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisolone; Prednisone; Remission, Spontaneous; Vinblastine; Vincristine

Topics: Adolescent; Antibiotics, Antineoplastic; Child; Child, Preschool; Clinical Trials as Topic; Colonic Neoplasms; Cyclophosphamide; Drug Combinations; Evaluation Studies as Topic; Female; Fluorouracil; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

In a prospective, nonrandomized trial clinical (initial WBC and chest film) and immunological (surface immunoglobulin and rosetting with pretreated sheep red blood cells) criteria were used to stratify 69 children with previously untreated acute lymphoid leukemia (ALL). Forty of 61 evaluable patients had low-risk ALL (initial WBC less than or equal to 20,000/mm3, no mediastinal mass) and were treated less intensively. Twenty-one of 61 patients had high-risk ALL (initial WBC greater than 20,000/mm3 and/or mediastinal mass) and were treated more intensively. Of the high-risk patients 15 had non-T non-B and 6 T ALL. Sixty of 61 patients went into complete remission. After a median observation period of 27 months, 32 of 40 low-risk, 7 of 14 high-risk non-T non-B, and none of 6 high-risk T ALL patients were in continuous first remission. Thirty-six of 40 low-risk, 9 of 15 high-risk non-T non-B, and none of 6 T ALL patients were alive. Despite more intensive treatment, the duration of remission and the survival were significantly shorter in the high-risk than in the low-risk patients. Among the high-risk ALL, non-T non-B ALL did better than T ALL.

Topics: Adolescent; Asparaginase; B-Lymphocytes; Child; Cyclophosphamide; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Leukocyte Count; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Receptors, Antigen, B-Cell; Remission, Spontaneous; Risk; T-Lymphocytes; Vincristine

A 34% response was obtained in 202 evaluable patients in the terminal phase of chronic granulocytic leukemia using combinations of hydroxyurea, 6-mercaptopurine, and corticosteroids. Twelve percent of responses were complete and 22% partial. Overall median survival was 12 wk. A 30 wk median survival for responding patients was statistically superior to the 7-wk survival for nonresponders (p less than 0.001). Response was inversely correlated with toxicity. No responses were obtained in patients sustaining both severe infectious and bleeding complications. No benefit could be demonstrated from the addition of vincristine in induction and daunorubicin for consolidation. Although the response frequency and duration of survival with this combination chemotherapy were generally superior to those previously reported by our group, the terminal phase of chronic granulocytic leukemia still remains a formidable and generally refractory disease.

Topics: Daunorubicin; Dexamethasone; Drug Therapy, Combination; Gastrointestinal Diseases; Hemorrhage; Humans; Hydroxyurea; Infections; Leukemia, Myeloid; Mercaptopurine; Prednisone; Remission, Spontaneous; Terminal Care

Combination chemotherapy with VM-26 and ara-C was given to 14 children with acute lymphocytic leukemia who had not responded to initial treatment with prednisone, vincristine, daunomycin, and asparaginase. Nine of these patients had also received ara-C. At diagnosis, five children were classified as having standard prognostic features and nine as being at high risk for treatment failure. The drug combination was administered by vein twice a week for four weeks at dosages of 165 mg/m2 for VM-26 and 300 mg/m2 for araC. Nine complete remissions, five in patients with high-risk leukemia, were induced with acceptable toxicity; all 9 subsequently were given continuation therapy with oral mercaptopurine and methotrexate. Four of the 9 patients have relapsed at 2--21 months. All treatment was stopped in 2 patients after 30 months of complete remission. Combinations of VM-26 and ara-C represent an alternative remission induction treatment for patients who fail to attain initial remission with agents of established effectiveness. These agents may especially benefit patients with prognostic features indicating a high risk of treatment failure.

Topics: Adolescent; Antineoplastic Agents; Bone Marrow Diseases; Child; Child, Preschool; Cytarabine; Drug Resistance; Drug Therapy, Combination; Female; Humans; Infant; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Podophyllotoxin; Remission, Spontaneous; Teniposide

Twenty-two children with acute lymphocytic leukemia (ALL) who had relapsed while on therapy and for whom remissions were successfully reinduced were maintained with a combination of methotrexate, daunomycin, 6-mercaptopurine, prednisone, and vincristine (Djerassi-methotrexate with BOMB). The median duration of remission was 35 weeks (range, five to 364+ weeks). Of 8 children (36%) did not relapse while receiving this therapy, 4 are off all therapy (durations of remissions, 40+, 97+, 132+, and 216+ weeks). Improved responses were found in children with platelet counts of greater than 10(5)/mm3 at the time of index relapse. Intrathecal chemotherapy seemed to greatly prolong the duration of remission for 16 children when compared to those children who did not receive IT therapy (45.5 vs. 24 weeks). No central nervous system relapses occurred. This maintenance regimen for children with previously relapsed ALL appears to be effective and worth additional clinical trials.

Topics: Adolescent; Antineoplastic Agents; Child; Child, Preschool; Daunorubicin; Drug Administration Schedule; Drug Therapy, Combination; Evaluation Studies as Topic; Female; Humans; Injections, Spinal; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Recurrence; Remission, Spontaneous; Vincristine

Topics: Child; Histiocytosis, Langerhans-Cell; Humans; Mercaptopurine; Prednisone; Recurrence; Remission, Spontaneous; Vinblastine

19 months after the clinical manifestation of acute lymphoblastic leukaemia, Hodgkin's disease, stage Ia, of the cervical lymphnodes developed in a 10 year old girl during continuous complete remission of leukaemia under chemotherapy. After a regional irradiation and after completing the antileukamic therapy the patient is at present off therapy, healthy and without signs of relapse of both malignant systemic diseases. The coincidence of acute lymphoblastic leukaemia in children with other malignant neoplasias is rare. The expected frequency of second malignancies and the theories concerning oncogenesis are shortly reviewed.

Topics: Child; Female; Hodgkin Disease; Humans; Leukemia, Lymphoid; Lymph Nodes; Mercaptopurine; Methotrexate; Methylprednisolone; Neck; Neoplasms, Multiple Primary; Remission, Spontaneous; Vincristine

From 1964-1975 43 children with non-Hodgkin's lymphoma (NHL) were treated. 60% of the patients had far advanced disease at diagnosis. Therapy before 1970 consisted of low dose irradiation to the primary and single agent chemotherapy; no C.N.S. irradiation to prevent meningeal recurrence was given. Median survival in this group was 5 months; all patients died. Since 1970 all children with NHL were entered into a modified leukaemia protocol regardless of stage or primary site. Therapy comprised an aggressive multiple drug combination, high dose local irradiation and prophylactic C.N.S. irradiation with intrathecal methotrexate. 41% of the patients treated since 1970 survive in continuous complete remission with a median observation time of 31+ (1-93+) months. All relapses occurred within 30 months after diagnosis. Stage of disease was the most important prognostic factor in our patients. Risk of a primary C.N.S. relapse in the total group was 30% for patients without prophylactic C.N.S. therapy compared to only 6% for patients with treatment.

Topics: Adolescent; Age Factors; Child; Child, Preschool; Cyclophosphamide; Female; Humans; Lymphoma; Male; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

Report on a case of acute childhood leukemia, who presents with the following exceptional features: During complete remission early bilateral leukemic infiltrations of the testes, followed--after an intervall of several months--by a serve, general relapse with ascites. New induction therapy resulted in a second complete remission, persisting for the next 8 years with 6MP as well as after cessation of therapy until up to more than 17 years. Comparable courses are not as yet on record.

Topics: Acute Disease; Adolescent; Adult; Blood Transfusion; Child; Child, Preschool; Humans; Leukemia; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Splenomegaly; Testicular Neoplasms

The degree to which anticancer drugs suppressed incorporation of tritiated thymidine into leukaemic cells was measured in 26 patients with acute leukaemia. Subsequent achievement of remission correlated best with suppression by cytosine arabinoside (ara-C). 6 of 7 patients with acute myelocytic and myelomonocytic leukaemia whose cells demonstrated suppression by ara-C of 3H-thymidine incorporation of 15% or less of control counts subsequently achieved remission, while 4 of 6 patients whose cells showed smaller degrees of inhibition did not achieve remission. Patients with acute lymphocytic leukaemia showed a similar pattern.

Topics: Adult; Aged; Cells, Cultured; Cyclophosphamide; Cytarabine; Depression, Chemical; Drug Therapy, Combination; Female; Humans; In Vitro Techniques; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Prognosis; Remission, Spontaneous; Thymidine; Tritium; Vincristine

An analysis of 66 children with ALL treated during the last 10 years shows an increase in medium survival time from 27.1 +/- 17.8 months to so far 39.3 +/- 15.1 months after the introduction of preventive CNS therapy. In the group with preventive CNS therapy both CNS relapses and hematological relapses are markedly reduced. Furthermore, in the group with preventive CNS therapy, patients initially treated with 3 drugs obviously survive longer than patients initially treated with only 2 drugs. Thus our study shows the importance of the quality of first remission for the further outcome of a patient with leukemia.

Topics: Brain Diseases; Child; Cyclophosphamide; Humans; Leukemia, Lymphoid; Life Expectancy; Mercaptopurine; Methotrexate; Methylprednisolone; Remission, Spontaneous; Vincristine

Evidence that the first human neoplasm systematically explored with chemotherapeutic treatments has apparently been cured in a palpable segment of affected patients evokes optimism for other types of cancer. The application of similar effort, similar logic, and quantitative experimental therapeutic approaches to the common cancers augurs well for cancer research and clinical medicine.

Topics: Antineoplastic Agents; Child; Daunorubicin; Drug Therapy, Combination; Follow-Up Studies; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Recurrence; Remission, Spontaneous; Vincristine

Topics: Adult; Antineoplastic Agents; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

Topics: Adolescent; Adrenal Cortex Hormones; Asparaginase; Bacterial Infections; Child; Child, Preschool; Colistin; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Infant; Injections, Spinal; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Remission, Spontaneous; Skull; Vincristine

42 patients with ALL were treated according to the following protocol: induction with vincristine + prednisone (+/- L-asparaginase), CNS-prophylaxis with cranial irradiation (2400 rads) and intrathecal methotrexate, maintenance for 3 years with 6-MP 50 mg/m2/d p.o. + MTX 75-150 mg/m2/2 wk i.v. X 4, alternating in a cyclic fashion with 6-MP 50 mg/m2/d p.o. + cyclophophshamide 600 mg/m2/2 wk i.v. X 4. The observation time is 24-67 (median 49) months. The actuarial complete remission curve shows 40% continuous complete remissions at 36 months and 30% at 60 months.--The frequency and temporal distribution of typical infectious complications are presented. The incidence of varicella was comparable to that in a southgerman normal control group (5,7% per year). During treatment there were two zoster manifestations per one varicella case, the incidence of zoster being 1 case per 106 patient-months, viz 11,4% per year.

Topics: Adolescent; Asparaginase; Chickenpox; Child; Child, Preschool; Cyclophosphamide; Female; Herpes Zoster; Humans; Infant; Injections, Spinal; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Skull; Vincristine

The most important advances achieved during the past 5 years in the diagnosis and treatment of acute leukemia are presented. It is now possible to achieve complete remission in about 60% of all patients with acute myelocytic leukemia (AML) using optimal polychemotherapy. This significant advance is in part due to improved supportive measures such as transfusions and isolation etc., which are frequently necessary during the induction phase of treatment. Unfortunately, such remissions are still of relatively short duration and seldom exceed 1 year. The treatment of relapses remains less successful. The first attempts to include immunotherapy in the treatment of AML have also been rather disappointing. Today remissions are obtained in 70% of patients with acute lymphocytic leukemia (ALL) which last, on the average, almost 1 1/2 years. These results, however, do not approach those in childhood ALL. Finally, the therapeutic possibilities for the treatment of blastic crisis in chronic myelocytic leukemia (CML) are discussed.

Topics: Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Mercaptopurine; Prednisone; Remission, Spontaneous; Thioguanine; Vincristine

Comparative results of chemo- and chemoimmunotherapy with Soviet strain of BCG vaccine in children with acute leukemia are presented. The immunotherapeutical regimen includes 20 intracutaneous injections of 0.1 mg BCG vaccine given weekly during 5--6 months with subsequent 5--6 months intervals simultaneously with maintenance chemotherapy. In the control group children were only given conventional chemotherapy. The median duration of remission and survival in patients who had received BCG chemoimmunotherapy was 25.2 +/- 1.5 and 32.3 +/- 1.2 months respectively. In the group of patients with chemotherapy alone--13.2 +/- 0.9 and 21.8 +/- 1.1 months respectively (p less than 0.01). The best results were obtained in children who had received before BCG immunotherapy neuroleukemia prophylactic treatment.

Topics: Adolescent; Antineoplastic Agents; BCG Vaccine; Brain Neoplasms; Child; Child, Preschool; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adolescent; Adult; Child; Daunorubicin; Drug Administration Schedule; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Time Factors; Vincristine

For the purpose of preventing a relapse of acute leukemia which is currently the major problem in the successful treatment of the disease, repeated consolidation or intensification therapy during the first year following remission is important. To evaluate these therapies, we investigated the serial changes in CFU-C's of the marrow cells from 12 patients with acute nonlymphocytic leukemia in remission and tried to estimate the relationship between the intensity of consolidation or intensification therapy and the duration of remission, utilizing the degree of reduction in CFU-C's seven days after these treatments as an indicator. As a result, after 21 out of 22 courses of therapy where CFU-C's were reduced significantly after the therapy, the patients were still in remission at the time of the next intensificiation therapy (at most for about 100 days). On the other hand, after five out of ten courses where CFU-C's were not reduced significantly, the patients were in relapse at the time of the next intensification therapy. From these results, it may be inferred that cases whose CFU-C's are not reduced significantly should be treated intensively again within a short period.

Topics: Acute Disease; Adult; Child; Colony-Forming Units Assay; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone; Remission, Spontaneous

67 children affected with acute lympocytic leukemia were immunologically evaluated for lymphocytic markers, serum immunoglobulins and delayed hypersensitivity skin tests at the onset, in remission and after cessation of therapy. E, EA rosettes and surface Ig assayed significantly lower in leukemic children than in matched controls, except for three cases of T-cell leukemia in which E rosettes were very high. After cessation of therapy almost normal results were obtained. As for serum Ig, the only abnormal finding was that of low IgM during therapy. The skin tests with Varidase, Candidine, Mumps antigen and DNCB were not significantly different at onset and in remission. As for DNCB test, the negative responses at onset often became positive in remission, but only when the test was performed before any treatment (anamnestic-like response?). One of the three patients with T-cell leukemia relapsed after 8 months: strangely enough, no surface marker could be detected on that occasion. We could not find any relationship between various immunological tests, or between these tests and prognosis; chemotherapy proved active in suppressing cellular immunity, especially the primary cellular response.

Topics: Adolescent; Child; Child, Preschool; Humans; Hypersensitivity, Delayed; Immunoglobulins; Infant; Leukemia, Lymphoid; Mercaptopurine; Prednisone; Remission, Spontaneous; Rosette Formation; T-Lymphocytes; Vincristine

Topics: Adolescent; Adult; Aged; Female; Humans; Male; Mercaptopurine; Middle Aged; Neoplasms; Remission, Spontaneous

This report describes the results of a study of central nervous system (CNS) prophylaxis and combination chemotherapy for the maintenance of remission in adult acute lymphoblastic leukemia. Adults with acute lymphoblastic leukemia who achieved complete remission were treated with 2,400 rads cranial irradiation and intrathecal methotrexate for CNS prophylaxis followed by continuation systemic chemotherapy with oral methotrexate, 6-mercaptopurine and cyclophosphamide. There were no CNS relapses following treatment. One-half of the patients relapsed within 11 months, with 5 patients remaining in remission for 27+ to 31+ months. The toxicity was acceptable with no treatment-related deaths. This regimen is capable of producing long remissions in a significant proportion of adults with acute lymphoblastic leukemia and appears to be effective in reducing the incidence of CNS relapse. It has the additional advantage of ease of administration and can be largely administered in the community.

Topics: Adolescent; Adult; Brain Neoplasms; Cyclophosphamide; Female; Head; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Middle Aged; Remission, Spontaneous; Spinal Cord Neoplasms

Continuation therapy using intermittent chemotherapy and BCG inoculation was commenced in 28 children with acute lymphocytic leukemia (ALL) immediately after remission induction and "CNS prophylaxis." At a median followup time of 17 months, 71% remain in total remission and 86% in bone marrow remission. Complications of the therapy were minimal. Major infections occurred on two occasions and there were no deaths in remission. Neutropenia, "minor" infections and postponement of chemotherapy occurred most often during the first three courses of treatment. There were no local or systemic BCG infections. Tuberculin sensitivity was tested in 25 patients. It was positive in 17 of 18 patients in total remission and all four patients with only CNS relapse, and was negative prior to relapse in three patients who developed bone marrow disease.

Topics: BCG Vaccine; Child; Child, Preschool; Drug Therapy, Combination; Humans; Infant; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Remission, Spontaneous; Vincristine

The therapeutic regimens for acute myelogenous leukemia in 2 different periods of time will be described with comparison of their results. A. 28 adults were treated with cytosine arabinoside and 6-thioguanine only. Thereby, 28% complete and 16% partial remissions were achieved. The mean duration of the complete remissions was 23 weeks. The mean survival time of the patients with complete remission amounted to 53 weeks B. 46% complete and 12% partial remissions were obtained in 37 patients treated with cytosine arabinoside and 6-thioguanine doubling the dosage of the above mentioned regimen followed by 3 cycles of TRAP (and COAP). Using a maintenance therapy with modified TRAP, COAP, and POMP cycles the complete remissions lasted 47 weeks at an average. The mean survival time of patients with complete remission was 87 weeks after start of treatment.

Topics: Adult; Aged; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Thioguanine; Time Factors; Vincristine

Topics: Central Nervous System Diseases; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Immunotherapy; Injections, Spinal; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Vincristine

Twenty-five patients with acute myeloid leukaemia were treated with three quadruple drug combinations in predetermined rotation: TRAP (thioguanine, daunorubicin, cytarabine, prednisolone); COAP (cyclophosphamide, vincristine, cytarabine, prednisolone); and POMP (prednisolone, vincristine, methotrexate, mercaptopurine). Fifteen patients (60%) achieved complete remission and five (20%) partial remission. For maintenance, five-day courses of drugs were administered every 14 to 21 days and doses were increased to tolerance. The median length of complete remission was 66 weeks. In eight patients remission maintenance treatment was discontinued and some remained in complete remission for over two years. In this series the remission induction rate was comparable with that reported for other regimens and complete remission lasted longer with this intensive maintenance regimen than with others. Nevertheless, the TRAP programme must still be regarded as only palliative treatment for acute myeloid leukaemia.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisolone; Remission, Spontaneous; Thioguanine; Vincristine

Induction chemotherapy consisting of vincristine, prednisone and L-asparaginase was given to 22 adult patients with acute lymphatic leukemia. Manintenance treatment consisted of methotrexate, 6-mercaptopurine, prednisone and vincristine. Of the 22 patients treated, 14 had a complete remission. The median remission duration was 14 months and the median survival 20 months. 8 further patients were included in an attempt to determine the significance of prognostic factors, but none of the parameters studied influence the course of disease with statistical significance. In general, younger patients and those with lower leukocyte counts at the time of diagnosis seemed to fare better.

Topics: Adult; Asparaginase; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Time Factors; Vincristine

Topics: Antineoplastic Agents; Asparaginase; Child; Daunorubicin; Humans; Immunotherapy; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

Topics: Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Humans; Leukemia, Lymphoid; Liver; Liver Function Tests; Mercaptopurine; Methotrexate; Remission, Spontaneous

Twin girls, genetically identical, probably experienced different leukemogenic events and presented with acute lymphocytic leukemia 6 years apart. Their clinical presentations were similar, but they received significantly different therapy. The first twin died 34 months after diagnosis following multiple remissions and relapses, having received single-drug maintenance. The second twin remains free of apparent disease 60 months after diagnosis, following vincristine and prednisone induction, 6-mercaptopurine maintenance, methotrexate and prednisone reinforcement, and central nervous system treatment of occult disease. Their dissimilar clinical courses may have been due to different leukemogenic events and/or markedly different therapeutic programs.

Topics: Antineoplastic Agents; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Drug Therapy, Combination; Female; Humans; Hydrocortisone; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Recurrence; Remission, Spontaneous; Vincristine

Eighteen (72%) of 25 evaluable and previously untreated patients with adult acute lymphoblastic leukemia entered complete remission (CR) following induction therapy with adriamycin, vincristine, and prednisone in a Southwest Oncology Group study. Remission maintenance therapy with methotrexate and 6-mercaptopurine resulted in a median duration of CR of 10.2 months. The addition of Adriamycin to prednisone and vincristine may be beneficial in slow responders or nonresponders to these two drugs and in patients with initially high peripheral blood blast counts.

Topics: Adolescent; Adult; Aged; Doxorubicin; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Vincristine

Acute lymphoblastic leukaemias which are, at the present time, curable are those which go 01.cfhçinto remission following treatment with the combination prednisone-vincristine, in which lymphoblastic meningitis does not occur after preventive treatment of the central nervous system and which show no recurrence during maintenance chemotherapy. In order that the largest possible number of these potentially curable patients may be transformed into truly cured cases, we propose here a simple outline of treatment: induction of remission by one month of treatment with prednisone 40 mg/m2/day and vincristine 1.5 mg/m2/week, immediately followed by treatment of the central nervous system: 2 400 rads to the brain down to C2 in two weeks and an half and 6 injection (2 per week) of intrathecal methotrexate 5 mg/m2/injection and maintenance chemotherapy for two years with 6 MP, 25 to 50 mg/m2/day and parenteral methotrexate, 10 to 15 mg/m2/week, then immunotherapy with BCG, for a minimum of three years and a maximum of five.

Topics: BCG Vaccine; Daunorubicin; Drug Administration Schedule; Drug Therapy, Combination; Humans; Immunotherapy; Injections, Spinal; Leukemia, Lymphoid; Long-Term Care; Lymphocytes; Meningeal Neoplasms; Mercaptopurine; Methotrexate; Mycobacterium bovis; Prednisone; Remission, Spontaneous; Vincristine

This paper compares anti-leukaemic efficiency with toxicity to the patient of chemotherapy during and immediately after central nervous system irradiation. The drug regimen consisted of daily mercaptopurine (MP) and weekly methotrexate (MTX) at the maximum tolerated dose. Of 140 patients with acute lymphoblastic leukaemia allocated to receive this drug regimen during and after cranial irradiation, 8 died in complete remission within 6 months of the end of irradiation. Details of the nature of these deaths are given. This result led the Working Party to modify the chemotherapy scheduled for this stage in treatment. The modified chemotherapy consisted of MP at reduced dosage before and during cranial irradiation and omission of MP and MTX for 3 weeks after irradiation, during which time daily prednisolone with 2 doses of vincristine were substituted. Following that, the treatment reverted to the original schedule of daily MP and weekly MTX at maximum tolerated dose. Of 109 patients allocated to this modified regimen only one died in remission within 24 weeks after cranial irradiation. Analysis of the anti-leukaemic effect of the modified regimen showed that up to 600 days it was at least as effective as the original more intensive regimen. We conclude that there is a definite advantage in keeping chemotherapy to a minimum during and immediately following cranial prophylactic irradiation.

Topics: Brain; Child; Child, Preschool; Female; Humans; Infection Control; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Remission, Spontaneous

The criteria for false positivity of the NBT test were described including absence of classical clinical signs of bacterial infection, negative blood (and, if necessary, other) cultures, and lack of response of antibacterial treatment as the basis for appreciation of positive NBT test result as false-positive. A case of acute lymphoblastic leukaemia with all the criteria being fulfilled was described.

Topics: Adult; Bacterial Infections; Cyclophosphamide; False Positive Reactions; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Nitroblue Tetrazolium; Recurrence; Remission, Spontaneous; Sulfamethoxazole; Tetrazolium Salts; Trimethoprim; Vincristine

Topics: Asparaginase; Child; Cyclophosphamide; Cytosine; Daunorubicin; Doxorubicin; Drug Therapy, Combination; Hodgkin Disease; Humans; Infant; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Lymphoma; Melphalan; Mercaptopurine; Methotrexate; Neoplasms; Nitrogen Mustard Compounds; Osteosarcoma; Prednisone; Procarbazine; Prognosis; Remission, Spontaneous; Rhabdomyosarcoma; Teniposide; Thioguanine; Vincristine; Wilms Tumor

The development of an effective therapeutic regimen for acute lymphocytic leukemia (ALL) of childhood is described. By careful surveillance of toxicity and efficacy, positive modifications of treatment strategy were achieved without resorting to classically randomized trails. Teh resultant protocol utilizes vincristine-prednisone induction followed by asparaginase consolidation, intensive intermittent combination maintenance chemotherapy with adriamycin as a major component, and cranial radiotherapy plus intrathecal methotrexate for central nervous system prophylaxis. Preliminary analysis suggests that this regimen may result in prolonged continuous complete remission in at least 80% of children with ALL.

Topics: Adolescent; Adult; Antineoplastic Agents; Asparaginase; Child; Child, Preschool; Doxorubicin; Drug Therapy, Combination; Female; Humans; Infant; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Radiotherapy, High-Energy; Remission, Spontaneous; Vincristine

Central nervous system (CNS) relapse is reported in three children with acute lymphocytic leukemia who received intermittent prophylactic CNS therapy with intrathecal methotrexate. The children were on monochemotherapy either with methotrexate or 6-mercaptopurine for 2 1/2 years. The CNS relapse occurred 2 1/2, 10 and 11 months after cessation of all chemotherapy. Irradiation and/or intensive chemotherapy including drugs as BCNU and Ara-C which are known to cross the blood-brain barrier were not given. Preventive CNS radiotherapy should be considered in all children who did not receive an adequate prophylactic CNS therapy even after long-term remission before chemotherapy is stopped.

Topics: Central Nervous System Diseases; Child, Preschool; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Remission, Spontaneous; Time Factors

Although these studies do not allow a definitive differentiation between the relative influence of chemotherapy and radiotherapy on mitogen-induced lymphocyte transformation, the data suggested both radiotherapy and chemotherapy can cause depression; however, radiotherapy may have a more pronounced effect. The relationship between the absolute peripheral blood lymphocyte count and phytohemagglutin and pokeweed mitogen-induced lymphocyte transformation was also analyzed. These data revealed that patients who are receiving or who have received intensive therapy may have normal peripheral absolute lymphocyte counts with impaired lymphocyte transformation. Serial studies of lymphocyte transformation were evaluated in 10 children with acute lymphoblastic leukemia who received both chemotherapy and radiotherapy.

Topics: Child; Cobalt Radioisotopes; Cytarabine; Drug Therapy, Combination; Humans; Immunity, Cellular; Leukemia, Lymphoid; Leukocyte Count; Lymphocyte Activation; Lymphocytes; Mercaptopurine; Methotrexate; Mitogens; Nitrogen Mustard Compounds; Prednisone; Remission, Spontaneous; Vincristine

Topics: Azathioprine; Crohn Disease; Humans; Immunosuppressive Agents; Mercaptopurine; Prednisolone; Remission, Spontaneous

In accordance with the recommendations of Pinkel, 147 children with acute lymphoblastic leukemia were treated by a combined cytostatic and radiation therapy during a joint study between May 1971 and Jan. 1, 1974. After a primary cytostatical treatment which brought about a remission of 94% of the patients within four to six weeks, the cranial irradiation was performed, depending on age, with a focal dose of 1500 up to 2400 rd in the course of three or four weeks. Simultaneously, the patients were given methotrexate intrathecally which was followed, later on, by a long-term therapy with cytostatics. By means of this combined treatment, a three-year survival was obtained in 50% (8 of 16) and a complete remission in 44% (7 of 16). The prognosis is the same for boys as for girls. A less favorable prognosis concerns the patients with an initial leukocytosisf more than 50 000 leukocytes/mm3 of blood, an age of more than ten years, and leukemic cells already demonstrable in the cerebrospinal fluid.

Topics: Acute Disease; Adolescent; Age Factors; Alopecia; Brain Neoplasms; Child; Child, Preschool; Cyclophosphamide; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Infant; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Premedication; Prognosis; Radiotherapy; Radiotherapy Dosage; Remission, Spontaneous; Skull; Vincristine

Topics: Child; Child, Preschool; Cyclophosphamide; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Time Factors; Vincristine; X-Rays

Topics: Adolescent; Adult; BCG Vaccine; Female; Humans; Injections, Intradermal; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Remission, Spontaneous; Vaccination

A case report of a patient who developed acute myelogenous leukemia 15 years after injection of Thorotrast and who has been in a sustained long term remission for 14 years is presented with a review of the problems associated with Thorotrast, subsequently shown to be radioactive with long term sequelae.

Topics: Adolescent; Angiography; Female; Humans; Leukemia, Myeloid, Acute; Leukemia, Radiation-Induced; Lymph Nodes; Mercaptopurine; Remission, Spontaneous; Spleen; Thorium Dioxide

In 87 cases of acute leukemia, leukemic and normal hematopoietic cell count in the bone marrow was serially observed, and the findings were used for evaluating the effectiveness of antileukemic agents and also for determining the grade of decrease in the marrow leukemic cell count required to start the proliferation of normal hematopoietic cells and to obtain complete remission of acute leukemia in adults.

Topics: Bone Marrow; Bone Marrow Cells; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Mercaptopurine; Prednisolone; Remission, Spontaneous; Vincristine

A regime of treatment of acute non-lymphoblastic leukemia in adult, employing DMCP protocol, especially two step method consisting of daunorubicin, cytosine arabinoside, 6-mercaptopurine and prednisolone is described. Out of 32 adult patients with ANLL treated with DCMP regime 26 (81.3%) achieved complete remission. The median durations of complete remission and survival were 53 weeks and 54 weeks, respectively. The longest duration of complete remission was more than 220 weeks, and 3 cases are still maintaining initial complete remission more than 3 years.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia; Leukemia, Erythroblastic, Acute; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone; Remission, Spontaneous

In acute lymphoblastic leukaemia the combination prednisone-vincristine induces more than 85% complete remissions. L-asparaginase which was used in complete remissions, seemed to increase their duration. Actually the best maintenance treatment consists in the combination of 6-mercaptopurine and methotrexate interrupted by reinductions. In other respects C.N.S. prophylaxis with intrathecal methotrexate and craniospinal irradiation is necessary. The well-known prognostic factors are: age, leucocytosis, tumoral syndrome, and cytological type: 216 cases of long remission have been observed. One group of these patients was treated by old methods: this represents 0.8 to 1% of the material, while 20% were treated by recent protocols with reinductions (20%).

Topics: Antineoplastic Agents; Asparaginase; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

The results of treatment of 84 acute leukaemia patients during a 15-year period are reported. Sixty-three of the patients suffered from acute myeloid leukaemia, 14 had blastic crisis of chronic leukaemia and 7 had acute myelomonocytic leukaemia. Administration of prednisolone + purinethol, prednisolone + vincristine, and prednisolone + vincristine + purinethol combinations resulted in partial remission. The best results were achieved with the combination ARA-C + thioguanine + prednisolone, which produced complete remission in 2 out of 8 cases. One patient was refractory to this treatment.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Child; Cytarabine; Drug Therapy, Combination; Humans; Leukemia, Myeloid, Acute; Mercaptopurine; Middle Aged; Prednisolone; Remission, Spontaneous; Thioguanine; Vincristine

The influence of four different cytotoxic drugs (MTX, CYC, 6MP, and ARA-C) on T, B, and O-lymphocytes was investigated in 20 children with ALL in complete remission during cyclic remission maintenance therapy. Each of the four drugs causes a marked reduction of the absolute number of T and B cells whereas the relative number lies within the normal range with the exception of CYC, which leads to a depression of the percentage of both T and B cells. The percentage of O cells is markedly increased by CYC and slightly increased by MTX, 6MP, and ARA-C. The data are interpreted with care since the function of the immune system and especially tumor rejection depends on the interaction between the different lymphocyte subpopulations.

Topics: Adolescent; Antineoplastic Agents; B-Lymphocytes; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Humans; Leukemia, Lymphoid; Leukocyte Count; Lymphocytes; Mercaptopurine; Methotrexate; Remission, Spontaneous; T-Lymphocytes

From own experiences the observations of 3 patients were reported who were immunosuppressively treated with purine antagonists (azathioprine and 6-mercaptopurine). Hereby in a severe allergic vasculitis in a 22-year-old patient and in a granulomatous arteritis during Wegener's granulomatosis in a 51-year-old patient remissions for more than 1 and 7 years, respectively, could be achieved under immunosuppressive long-term therapy. In the case of a periarteriitis nodosa death took place 2 months after administration of 6-mercaptopurine.

Topics: Adult; Aged; Arteritis; Azathioprine; Humans; Immunosuppressive Agents; Male; Mercaptopurine; Middle Aged; Polyarteritis Nodosa; Remission, Spontaneous; Time Factors; Vascular Diseases

Radioimmunoassays and bioassays based on the reactions of the native molecule of human chorionic gonadotropin (HCG) fail to differentiate HCG from pituitary luteinizing hormone (LH). An assay based on the beta-subunit of HCG which detects HCG exclusively has been used in our laboratory to monitor patients undergoing chemotherapy for gestational trophoblastic disease (GTD). We have been able to differentiate minimal, persisting tumor activity from normal levels of pituitary gonadotropins and have based therapy on these findings. Alternatively, treatment has been terminated when HCG is no longer detectable in the serum. Tumor activity has been detected in the beta-subunit assay at a time when biologic activity in the urine indicated remission.

Topics: Adult; Antineoplastic Agents; Biological Assay; Bleomycin; Chlorambucil; Choriocarcinoma; Chorionic Gonadotropin; Dactinomycin; Female; Follow-Up Studies; Humans; Hydatidiform Mole; Hydatidiform Mole, Invasive; Luteinizing Hormone; Mercaptopurine; Methotrexate; Monitoring, Physiologic; Neoplasm Metastasis; Pregnancy; Radioimmunoassay; Remission, Spontaneous; Trophoblastic Neoplasms

The quality of life in leukaemia is as important as its quantity. In fifty-one patients the quality and quantity of life were improved by less aggressive treatment than is usual. By not trying to induce complete remission at all costs, the mobidity and early mortality were reduced and at least an equivalence in survival was obtained.

Topics: Acute Disease; Adolescent; Adult; Aged; Allopurinol; Bacterial Infections; Cytarabine; Daunorubicin; Drug Therapy, Combination; Focal Infection, Dental; Follow-Up Studies; Humans; Length of Stay; Leukemia, Myeloid, Acute; Mercaptopurine; Middle Aged; Philosophy; Quality of Life; Remission, Spontaneous

Problems of maintaining therapy for acute myelocytic leukemias in adults are discussed. The analysis of the maintaining therapy in 22 patients affected with an acute myelocytic leukemia and living for more than 6 months revealed that the interval therapy with a high dosage of cytostatic combinations in the sense of the COAP scheme is preferable compared with the daily administration of 6-mercaptopurin, in addition methotrexate twice a week. Reasons for this are discussed.

Topics: Cyclophosphamide; Cytarabine; Drug Therapy, Combination; Female; Humans; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Vincristine

A malignant hepatoma occurred in a 12-year-old girl who eight years previously had developed an acute lymphoblastic leukaemia which for eight years had been in complete haematological remission. Fourteen months after the last re-induction treatment period had been discontinued, but while on methotrexate and 6-mercaptopurine maintenance, a hepatocellular liver carcinoma developed of which the patient died after a fulminating course, still in complete haematological remission. As far as is known, no direct carcinogenic effect can be ascribed to the two antimetabolites, but it must be assumed that these two drugs, taken by the patient for over seven years, led to cirrhosis of the liver whose malignant transformation was significantly influenced by the immunosuppressive effects of methotrexate and 6-mercaptopurine, given as maintenance therapy according to protocol 02 LA 64, Paris.

Topics: Carcinoma, Hepatocellular; Child; Female; Humans; Leukemia, Lymphoid; Liver Cirrhosis; Liver Neoplasms; Mercaptopurine; Methotrexate; Remission, Spontaneous; Time Factors

Although definite improvement in the treatment of acute myelogenous leukemia has taken place, the outlook for patients remains grim. The current aggressive approach to treatment, entailing a program of chemotherapy which almost invariably produces bone marrow aplasia and considerable toxicity, has been the subject of some controversy. Selected aspects of management are discussed.

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Antineoplastic Agents; Blood Transfusion; Cell Division; Cyclophosphamide; Cytarabine; Drug Evaluation; Drug Synergism; Drug Therapy, Combination; Humans; Infection Control; Kinetics; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Mycoses; Prednisone; Pseudomonas Infections; Remission, Spontaneous; Thioguanine; Vincristine

Topics: Antigens, Neoplasm; Cell Migration Inhibition; Child; Humans; Immune Sera; Leukemia, Lymphoid; Leukocytes; Mercaptopurine; Methotrexate; Remission, Spontaneous

A total of 114 previously untreated patients with myeloblastic leukemia was included in a sequential therapy protocol. Daunorubicin, vincristine, and prednisone were employed for the first 3 weeks, followed by two or more 5-day courses of cytosine arabinoside and 6-mercaptopurine; there was a 5-day rest between courses. Maintenance therapy was as follows: the continuing 6-mercaptopurine and methotrexate treatment was interrupted every 30 days for sequential reinforcement courses consisting of one dose of daunorubicin and vincristine and 7 days of prednisone, or by a 5-day course of cytosine arabinoside plus 6-mercaptopurine. Of the 114 patients, 48 obtained complete remission, 14 had partial remission, 16 failed to respond, and 36 died during the course of treatment. The remission rate in children (under 16) was 57%; in adults (16-45) 54%; and in those over 45, 19%. The difference in the incidence of complete remission in patients under 45 and those over 45 was statistically significant (p less than 0.01). The median duration of complete remission was 8 months: 12 months in children and 5 months in adults. The over-all survival rate was 4 months: 13 months for patients with complete remission, 4 months for those with partial remission, and 1 month for patients who did not respond to therapy. The difference in survival of those with complete remission and all the others was significant (p less than 0.01).

Topics: Adolescent; Adult; Age Factors; Antineoplastic Agents; Child; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Acute Disease; Adolescent; Daunorubicin; Drug Therapy, Combination; Hodgkin Disease; Humans; Leukemia, Lymphoid; Male; Mechlorethamine; Mercaptopurine; Prednisone; Procarbazine; Remission, Spontaneous; Sulfates; Vincristine

Topics: Administration, Oral; Adolescent; Alkaloids; Antineoplastic Agents; Carbazoles; Child; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Injections, Intravenous; Leukemia, Myeloid, Acute; Mercaptopurine; Methyl Ethers; Prednisone; Remission, Spontaneous; Time Factors

Long-term second remissions were seen in 5/66 patients with all. Relapse was extramedullary in 2/5. Persistent, progressive marrow lymphocytosis preceded relapse in 4/5 patients and persistent marrow eosinophilia in 1/5. All 5 patients had had an unmaintained remission of at least 6 months prior to relapse, and responded the second time to drugs which were essentially the same as those used initially. We conclude that long-term second remissions may occur in all. Patients who relapse after 6 months or more of unmaintained remission should be treated with the drugs used in current initial induction regimens in hope of cure.

Topics: Adolescent; Antineoplastic Agents; Child; Child, Preschool; Cyclophosphamide; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Neoplasm Recurrence, Local; Prednisolone; Prednisone; Remission, Spontaneous; Vincristine

The effects of six clinically active drugs were tested against a ttansplantable leukemia in inbred strain 2 guinea pigs. Cytoxan and 6-mercaptopurine were found to elicit a therqeutic response against this leukemia based on complete tumor regression of the established tumor as well as a substantial increase in survival time. Animals dying in the untreated control and drug-treated groups revealed typical generalized lymphoblastic leukemia. However, only Cytoxan-treated animals that had relapsed exhibited central nervous system involvement originating from the arachnoid membrane. A tow-drug combination of Cytoxan and 1-(2-chloroethyl)-3(trans-4-methylcyclohexyl)-1-nitrosourea was found not only to prevent meningeal leukemia development but also to result in "curing" all animals from their leukemia. This observation was based on a complete clinical, hematological, and histopathological "remission" period up to 176 days. The administration of 1-(2-chloroethyl)-3-(trans-4-methylcyclohexyl)-1-nitrosourea alone was observed not only to control the systemic leukemia but also to prevent central nervous system involvement. No relapses occurred after the first "remission" period was achieved in the groups of animals that received 1-(2-chloroethyl)-3-(trans-4-methylcyclohexyl)-1-nitrosourea.

Topics: Animals; Antineoplastic Agents; Brain Neoplasms; Cyclohexanes; Cyclophosphamide; Drug Therapy, Combination; Guinea Pigs; Leukemia, Experimental; Leukemia, Lymphoid; Male; Meninges; Mercaptopurine; Neoplasm Transplantation; Nitrosourea Compounds; Prednisolone; Remission, Spontaneous; Vincristine

Topics: Acute Disease; Age Factors; Animals; Antineoplastic Agents; Asparaginase; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Mitosis; Neutropenia; Prednisone; Remission, Spontaneous; Vincristine

The in vitro sensitivity of leukemic cells to cytotoxic drugs was assessed in 61 cases of acute leukemia in adults, 49 of them were of the no lymphoblastic type and in the first phase of the disease. The depression of the incorporation of 14-C-thymidine and 3-H-uridine after a two hours incubation with the various cytotoxic drugs was compared with the clinical result obtained with two of them There is a significant correlation between the in vitro depression of the incorporation of 14-C-thymidine and the clinical effect of the drugs. This method, which may be utilized also in solid tumors, allows to predict with some accuracy the effect of chemotherapy, and to select between the various cytotoxic drugs. However the failure of a chemotherapy is generally related to an in vitro insensitivity of the malignant cells to almost all drugs.

Topics: Acute Disease; Adolescent; Adult; Aged; Antineoplastic Agents; Asparaginase; Carbon Radioisotopes; Cells, Cultured; Cyclophosphamide; Cytarabine; Daunorubicin; Depression, Chemical; Humans; In Vitro Techniques; Leukemia; Leukemia, Lymphoid; Mercaptopurine; Middle Aged; Monomethylhydrazine; Prednisolone; Remission, Spontaneous; Thymidine; Tritium; Uridine; Vincristine

Remission induction was assessed by clinical and cell-culture criteria for 65 patients with acute myelogenous leukemia (AML), 11 patients with chronic myelogenous leukemia (CML) in blast crisis and 19 patients with acute lymphoblastic leukemia (ALL). Cyclophosphamide, cytosine arabinoside and vincristine (CAV) therapy resulted in complete remission in 23 of 50 previously untreated patients with AML and in 3 of the 11 patients with CML. Fourteen patients with ALL responded to vincristine-prednisone induction therapy and two to induction therapy with CAV. The median duration of survival of the responding patients was 2.2 years, compared with 4 months for the patients who did not respond to treatment. Granulopoietic colony formation, assessed by assay of colony-forming units dependent on colony-stimulating activity in culture (CFU-C), was abnormal in 37 of 42 bone marrow aspirates from patients with AML before treatement. CFU-C concentration increased when leukocyte-conditioned medium (LCM) was added to the cultures; 13 cultures had normal or elevated CFU-C concentration with LCM. Marrow cells of patients with ALL or CML in blast crisis demonstrated a similar pattern. Serial studies of marrow CFU-C concentration of 31 patients with AML demonstrated a change to a normal pattern with successful remission induction. Results of this study suggest that administration of purified LCM to leukemic patients might increase granulocyte production from potential but unstimulated granulopoietic precursors. This therapy would lessen the probability of death from infection during remission induction.

Topics: Acute Disease; Adolescent; Adult; Aged; Bone Marrow; Bone Marrow Cells; Cell Division; Cells, Cultured; Clone Cells; Culture Media; Cyclophosphamide; Cytarabine; Drug Administration Schedule; Drug Therapy, Combination; Female; Granulocytes; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Vincristine

A greek boy is described in whom pulmonary tuberculosis and homozygous beta-thalassemia was discovered at 4 years of age. Tuberculosis was cured after 1 year of combined tuberculostatic chemotherapy. His thalassemia only required 1-2 blood transfusions per year. Acute lymphoblastic leukemia was diagnosed in the patient at 8 years of age and treated with antileukemic combination chemotherapy and cranial irradiation. 7 months after diagnosis the boy is still in continuous complete remission under antileukemic chemotherapy without requiring blood transfusions.

Topics: Blood Transfusion; Child; Cyclophosphamide; Drug Therapy, Combination; Germany, West; Greece; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Skull; Thalassemia; Time Factors; Tuberculosis, Pulmonary; Vincristine

A 13-year-old female was on maintenance therapy for acute lymphoblastic leukemia. On three occasions she received methotrexate orally and each time this was associated with reactivation of scabies rash. The mechanisms for this phenomenon are discussed.

Topics: Adolescent; Benzyl Compounds; Cytarabine; Female; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Scabies; Vincristine

During a 7 1/2-yr period we monitored a chromosomally aberrant cell line in a woman with acute granulocytic leukemia (AGL) whose disease followed a rather unusual course. Her initial remission induced with 6-mercaptopurine (6-MP) and prednisone was maintained for 52 mo with biweekly doses of methotrexate (MTX) given orally. Because signs of liver dysfunction occurred, maintenance therapy was stopped. After 15 mo without chemotherapy, she suffered her first relapse (5 yr 7 mo after the initial diagnosis). A second remission, again induced with 6-MP and prednisone, was maintained for 1 yr, after which a second relapse occurred. Another remission lasting for only 4 mo was followed by a relapse of the leukemic process which led to her death. Cytogenetic studies of marrow cells and peripheral blood at the time of her initial diagnosis showed abnormal stem lines with characteristic chromosome markers. A small percentage of malignant cells bearing these markers persisted in her marrow during the years of her prolonged remission. At the time of her first relapse, 75% of her marrow cells had the marker karyotype, and at the time of her death (7 1/2 yr after the leukemia was diagnosed) all analyzable marrow metaphases had the characteristic chromosome changes.

Topics: Adolescent; Bone Marrow; Bone Marrow Cells; Cells, Cultured; Chromosome Aberrations; Fatty Liver; Female; Humans; Karyotyping; Leukemia, Myeloid, Acute; Liver; Mercaptopurine; Mitosis; Necrosis; Prednisone; Remission, Spontaneous

Topics: Cell Transformation, Neoplastic; Child; Cyclophosphamide; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Remission, Spontaneous; Time Factors

Twelve children with acute lymphocytic leukemia who had been in complete remission on continuous chemotherapy for at least 12 months, were treated with intermittent courses of chemotherapy alternating with BCG inoculation during the drug-free intervals. Measurements were made of leukocyte populations in blood and bone marrow leukemic blastogenic responses of blood lymphoid cells to phytohemmagglutinin and soluble leukemic blast cell membrane antigen. Antibody titers to a soluble leukemic blast-cell membrane-derived antigen were determined. Comparison was made with similar measurements during a second phase of intermittent chemotherapy without BCG inoculation (phase II). Two children showed bone-marrow relapse and two developed central nervous system leukemia during the study. Rises in blood and bone-marrow lymphoid cell numbers were found during both phases of the study. Blastogenic responses to phytohemagglutinin, depressed at the start of the study following at least 12 months of continuous chemotherapy, rose during intermittent chemotherapy and BCG and remained within normal ranges during phase II. Antibody titers and blastogenic responses to leukemia blast-cell membrane antigens increased in eight of twelve and six of seven children respectively during the BCG phase and were maintained during phase II. Only one child showed further increases in phase II. The combination of BCG and intermittent chemotherapy may increase leukemia-associated immunity in some patients with acute lymphocytic leukemia in remission. The separate contributions of either BCG or intermittent chemotherapy in producing this effect cannot be determined by this study.

Topics: Antibodies, Neoplasm; Antigens, Neoplasm; BCG Vaccine; Bone Marrow Cells; Cell Membrane; Child; Child, Preschool; Cyclophosphamide; Drug Therapy, Combination; Female; Humans; Immune Adherence Reaction; Immunotherapy; Leukemia, Lymphoid; Leukocyte Count; Male; Mercaptopurine; Methotrexate; Remission, Spontaneous; Skin Tests; Vincristine

Eighteen children with acute myeloid leukemia have been treated with a four-drug protocol using cytosine arabinoside, daunorubicin, prednisolone, and mercaptopurine or thioguanine. The initial remission rate overall was 78%. Of 15 children who completed a week's treatment, i.e. one complete cycle, 14 entered complete remission (93%). The median survival was 7 months, and the median survival for those entering remission was 12 1/2 months.

Topics: Antineoplastic Agents; Child; Child, Preschool; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Infant; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Prednisolone; Remission, Spontaneous; Thioguanine

27 adult patients with acute lymphocytic leukemia have been analyzed. Complete remission was induced in 9 of 113 patients treated with prednisone +6-MP, 4 of 6 patients treated with prednisone + vincristine, and the one patient treated with a combination of prednisone, vincristine, 6-MP, and methotrexate. The median survival for these 20 patients was 11 months and the median duration of complete remission was 71/2 months. Two of these patients remain in complete remission at 8+ years. Our most recent regimen for remission induction, prednisone + vincristine + daunomycin, has produced complete remission in 7 of 7 patients, with a median duration of complete remission of 15 months. Three patients remain in their original complete remission from 16+ to 24+ months, and 5 of these 7 patients remain alive from 16+ to 24+ months.

Topics: Adolescent; Adult; Central Nervous System; Daunorubicin; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Vincristine

Acquired erythroblastic aplasia of adults is a rare disease characterised by the absence of red cell precursors in the bone marrow. In a 34-year-old female patient the disease has been known for seven years. A partial remission had at first been achieved with glucocorticoids but regular transfusions had been necessary since 1971. Treatment with cyclophosphamide produced a remission which has lasted for over twelve months up to now. Histology of the bone marrow biopsy shows the appearance of active erythropoiesis after cyclophosphamide treatment which reflects well the clinical course.

Topics: Adult; Anabolic Agents; Anemia, Aplastic; Antibody Formation; Antilymphocyte Serum; Azathioprine; Cyclophosphamide; Female; Humans; Immunosuppressive Agents; Male; Mercaptopurine; Middle Aged; Prednisone; Prognosis; Remission, Spontaneous; T-Lymphocytes; Testosterone; Vitamin B 12

An overview is presented of the improvements in the prognosis of acute lymphocytic leukemia due to combined modality therapy. With the best available regimens, approximately 50% of these children have remained leukemia-free for 5 years or more. Because of these results, there is growing concern for the quality of survival and for the side effects of therapy. A case in point is a completely unexpected side effect in a current study. Nonleukemic leukoencephalopathy has developed in 8 of 20 children given intravenous methotrexate, 50-80 mg/m2 per week, as the sole agent following remission induction and CNS therapy. Thus, with longer remissions and survivals now commonly observed, a concerted effort is needed to minimize side effects while trying to improve further the efficacy of therapy.

Topics: Child; Cyclophosphamide; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Pneumonia, Pneumocystis; Remission, Spontaneous

Thirteen patients with Wegener's granulomatosis have been treated with cytotoxic agents. Only one died from the disease whereas two died of infectious complications of therapy and one of heart disease. Seven of the nine survivors are well without medication; one is alive with renal insufficiency and one is in the 5th year of treatment. Cholorambucil was least toxic and should be tried first. Cyclophosphamide was more effective than cholorambucil or azathioprine but, because of side effects, should rarely be used initially. Differentiation of Wegener's granulomatosis from lymphomatiod granumatosis, which it resembles clinically, roentgenologically and pathologically, is important since the latter disease responds differently to cytoxic drug therapy.

Topics: Azathioprine; Cyclophosphamide; Drug Evaluation; Granuloma; Granulomatosis with Polyangiitis; Hodgkin Disease; Humans; Lung Diseases; Mercaptopurine; Prednisone; Prognosis; Remission, Spontaneous

Topics: Bone Marrow Cells; Child; Cyclophosphamide; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Periodic Acid; Peroxidases; Prednisone; Prognosis; Remission, Spontaneous; Staining and Labeling; Vincristine

Topics: Bone Marrow Examination; Child; Child, Preschool; Daunorubicin; Drug Therapy, Combination; Evaluation Studies as Topic; Hematopoietic Stem Cells; Histocytochemistry; Humans; Infant; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Periodic Acid; Peroxidases; Prednisone; Prognosis; Remission, Spontaneous; Retrospective Studies; Staining and Labeling; Vincristine

Topics: Adolescent; Adrenocorticotropic Hormone; Alpha-Globulins; Antibodies, Antinuclear; Antimetabolites; Azathioprine; Blood Protein Electrophoresis; Calcinosis; Child; Creatine; Dermatomyositis; Electromyography; Exercise Therapy; Female; Fluorescent Antibody Technique; Fructose-Bisphosphate Aldolase; Growth Disorders; Humans; Immunosuppression Therapy; L-Lactate Dehydrogenase; Male; Mercaptopurine; Methotrexate; Middle Aged; Muscles; Prednisone; Remission, Spontaneous; Staphylococcal Infections; Transaminases

Topics: Adult; Choriocarcinoma; Chorionic Gonadotropin; Dactinomycin; Drug Therapy, Combination; Female; Humans; Hydatidiform Mole; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Pregnancy; Remission, Spontaneous; Trophoblastic Neoplasms

Topics: Brain Neoplasms; Child; Child, Preschool; Cyclophosphamide; Cystitis; Drug Therapy, Combination; Female; Herpes Zoster; Herpesvirus 3, Human; Humans; Infant; Infections; Leukemia; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Pneumonia, Viral; Prednisone; Remission, Spontaneous; Skin Diseases; Vincristine; Viral Vaccines; Virus Diseases

Topics: Acute Disease; Adult; Age Factors; Aged; Drug Therapy, Combination; Female; Humans; Leukemia; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adolescent; Adult; Antineoplastic Agents; Azathioprine; Chlorambucil; Chronic Disease; Cyclophosphamide; Female; Follow-Up Studies; Humans; Male; Mercaptopurine; Middle Aged; Nephritis; Remission, Spontaneous; Time Factors

Topics: Acute Disease; Adolescent; Adult; Female; Follow-Up Studies; Humans; Leukemia; Mercaptopurine; Prednisone; Remission, Spontaneous; Time Factors

Topics: Adolescent; Adult; Age Factors; Aged; Child; Daunorubicin; Female; Humans; Hypersensitivity, Delayed; Immunity, Cellular; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Nitrobenzenes; Prednisone; Prognosis; Remission, Spontaneous; Sex Factors; Skin Tests; Vincristine

Topics: Age Factors; Bone Marrow Examination; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Hydroxyurea; Leukemia, Myeloid, Acute; Mercaptopurine; Nitrosourea Compounds; Prednisone; Remission, Spontaneous; Thioguanine; Vincristine

Topics: Adolescent; Adult; Age Factors; Azauridine; Child; Child, Preschool; Cytarabine; Drug Therapy, Combination; Female; Hepatomegaly; Humans; Leukemia, Myeloid, Acute; Liver; Lymph Nodes; Male; Mercaptopurine; Remission, Spontaneous; Spleen; Splenectomy; Splenomegaly; Vincristine

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Asparaginase; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Methylprednisolone; Middle Aged; Paresis; Prognosis; Radiotherapy Dosage; Remission, Spontaneous; Vincristine

Topics: Bone Marrow Cells; Child; Child, Preschool; Diet; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Leukocyte Count; Male; Mercaptopurine; Methotrexate; Prednisolone; Prognosis; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adult; Eye Manifestations; Humans; Iris; Leukemia; Leukemia, Lymphoid; Male; Meninges; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

Topics: Cytarabine; Daunorubicin; Drug Synergism; Glyoxal; Humans; Leukemia, Myeloid, Acute; Mercaptopurine; Remission, Spontaneous

Topics: Asparaginase; Child; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

Topics: Acute Disease; Child; Child, Preschool; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Brain Neoplasms; Child; Child, Preschool; Cross Infection; Cyclophosphamide; Drug Therapy, Combination; Female; Humans; Infant; Injections, Intravenous; Leukemia; Leukemia, Lymphoid; Male; Measles; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Spinal Neoplasms; Vincristine

Topics: Adult; Central Nervous System Diseases; Child; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

Topics: Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Infant; Leukemia, Myeloid, Acute; Mercaptopurine; Middle Aged; Prednisone; Remission, Spontaneous; Vincristine

Topics: Antigens, Neoplasm; Cell Migration Inhibition; Child; Humans; Immune Sera; Leukemia, Lymphoid; Leukocytes; Mercaptopurine; Methods; Methotrexate; Remission, Spontaneous

Topics: Adult; Drug Therapy, Combination; Female; Humans; Leukemia, Lymphoid; Mercaptopurine; Prednisolone; Remission, Spontaneous; Time Factors

Topics: Arachnoid; Asparaginase; Brain Neoplasms; Cerebrospinal Fluid; Child; Cyclophosphamide; Daunorubicin; Drug Therapy, Combination; Follow-Up Studies; Humans; Immunotherapy; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Prednisolone; Prednisone; Remission, Spontaneous; Vincristine

Phagocytosis and bacterial capacity of peripheral blood leucocytes were studied in 49 children with acute lymphoblastic leukaemia. No impairment of phagocytic ability was found, but 36% of children in relapse and 25% in remission had varying degrees of diminished intracellular killing capacity of ingested Staphylococcus aureus. Serial values in the same individual were constant irrespective of drugs used or stage of the disease. There was a highly significant positive correlation between bactericidal capacity ratio and the number of episodes of infection per patient; there was no significant correlation with death from infection.

Topics: Adolescent; Blood Bactericidal Activity; Child; Child, Preschool; Cyclophosphamide; Female; Humans; Infant; Leukemia, Lymphoid; Leukocytes; Male; Mercaptopurine; Methotrexate; Phagocytosis; Prognosis; Remission, Spontaneous; Staphylococcal Infections; Vincristine

Topics: Child; Common Cold; Hepatitis B; Humans; Influenza, Human; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Mouth Diseases; Prednisone; Remission, Spontaneous; Time Factors; Ulcer; Vincristine

Topics: Adolescent; Asparaginase; Blood Platelets; Blood Transfusion; Cephalosporins; Child; Child, Preschool; Drug Therapy, Combination; Female; Gentamicins; Humans; Infant; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Prednisolone; Prognosis; Radiotherapy; Remission, Spontaneous; Vincristine

Topics: Adolescent; Adult; Antineoplastic Agents; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia, Myeloid, Acute; Mercaptopurine; Middle Aged; Prednisolone; Remission, Spontaneous; Thioinosine

Topics: Child, Preschool; Cyclophosphamide; DNA, Neoplasm; Female; Humans; Immunosuppressive Agents; Lectins; Leukemia, Lymphoid; Lymphocyte Activation; Lymphocytes; Lymphotoxin-alpha; Mercaptopurine; Methotrexate; Remission, Spontaneous; Time Factors

Topics: Anemia, Aplastic; Autoimmune Diseases; Bone Marrow; Bone Marrow Cells; Female; Fluorescent Antibody Technique; Humans; Immunoglobulin G; Immunosuppressive Agents; Mercaptopurine; Middle Aged; Remission, Spontaneous

Topics: Adolescent; Adult; Aged; Cyclophosphamide; Drug Therapy, Combination; Female; Humans; Lymphoma, Non-Hodgkin; Male; Mercaptopurine; Methotrexate; Middle Aged; Moscow; Prednisolone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Age Factors; Child, Preschool; Dactinomycin; Humans; Leukemia, Lymphoid; Leukocyte Count; Mercaptopurine; Methotrexate; Models, Biological; Nitrogen Mustard Compounds; Prognosis; Regression Analysis; Remission, Spontaneous; Statistics as Topic; Time Factors

Topics: Acute Disease; Adult; Antineoplastic Agents; Cytarabine; Daunorubicin; Drug Therapy, Combination; Humans; Leukemia; Mercaptopurine; Middle Aged; Prednisone; Remission, Spontaneous; Retrospective Studies; Vincristine

Topics: Acute Disease; Bone Marrow Examination; Cell Transformation, Neoplastic; Dexamethasone; Drug Therapy, Combination; Glucocorticoids; Humans; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Prednisolone; Prednisone; Remission, Spontaneous; Vincristine

Topics: Acute Disease; Asparaginase; Bone Marrow Examination; Bone Neoplasms; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Radiography; Remission, Spontaneous; Urticaria Pigmentosa; Vincristine

Topics: Antineoplastic Agents; Asparaginase; Cyclophosphamide; Cytarabine; Daunorubicin; Doxorubicin; Drug Synergism; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Thioguanine; Vincristine

Topics: Adolescent; Adult; Antineoplastic Agents; Child; Daunorubicin; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adolescent; Adult; Age Factors; Aged; Blood Platelets; Blood Transfusion; Cytarabine; Daunorubicin; Female; Humans; Hydrazines; Hyperplasia; Leukemia, Myeloid; Leukocyte Count; Leukopenia; Male; Mercaptopurine; Methotrexate; Middle Aged; Remission, Spontaneous; Thrombocytopenia; Time Factors

Topics: Administration, Oral; Adolescent; Antineoplastic Agents; Cyclophosphamide; Drug Synergism; Follow-Up Studies; Humans; Infertility, Male; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Paternity; Prednisone; Remission, Spontaneous; Spermatozoa; Time Factors

Topics: Age Factors; Child; Female; Fractures, Spontaneous; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Osteoporosis; Prednisone; Radiography; Remission, Spontaneous; Spinal Diseases; Thoracic Vertebrae

Topics: Child; Female; Humans; Hypersplenism; Leukemia, Lymphoid; Leukocytes; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Splenectomy

Topics: Acute Disease; Bone Marrow Cells; Child; Cyclophosphamide; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Vincristine

Topics: Child; Child, Preschool; Copper; Hepatomegaly; Humans; Infant; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Remission, Spontaneous; Spectrophotometry, Atomic; Splenomegaly; Zinc

Topics: Adolescent; Adult; Age Factors; Antineoplastic Agents; Bone Marrow; Digestive System; Evaluation Studies as Topic; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Liver; Mercaptopurine; Methotrexate; Middle Aged; Paresthesia; Prednisone; Prognosis; Remission, Spontaneous; Time Factors; Vincristine

Topics: Acute Disease; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

Topics: Adenine; Adolescent; Adult; Aged; Antimetabolites; Drug Resistance; Female; Guanine; Humans; Hypoxanthines; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocytes; Male; Mercaptopurine; Mutation; Pentosyltransferases; Remission, Spontaneous; Thioguanine

Topics: Acute Disease; Child; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

Topics: Acute Disease; Adolescent; Age Factors; Child; Child, Preschool; Female; Humans; Infant; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cytarabine; Evaluation Studies as Topic; Female; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Remission, Spontaneous; Time Factors; Vincristine

Topics: Acute Disease; Age Factors; Central Nervous System; Central Nervous System Diseases; Child; Cyclophosphamide; Cytarabine; Drug Therapy, Combination; Humans; Injections, Spinal; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Radiation Effects; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adolescent; Adult; Bone Marrow Cells; Bone Marrow Examination; Cell Count; Cell Division; Child; Clone Cells; Culture Techniques; Cytarabine; Daunorubicin; Drug Therapy, Combination; Embryo, Mammalian; Female; Humans; Kidney; Leukemia, Myeloid, Acute; Leukocytes; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisolone; Remission, Spontaneous; Thioguanine; Vincristine

Topics: Adolescent; Adult; Allopurinol; Bone Marrow Cells; Cell Count; Child; Child, Preschool; Culture Techniques; Cytarabine; Drug Therapy, Combination; Embryo, Mammalian; Female; Humans; Injections, Spinal; Kidney; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Remission, Spontaneous; Vincristine

Topics: Administration, Oral; Adult; Aged; Child; Cytarabine; Drug Therapy, Combination; Evaluation Studies as Topic; Female; Humans; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Remission, Spontaneous

Topics: Acute Disease; Adult; Child; Female; Humans; Leukemia; Leukemia, Lymphoid; Mercaptopurine; Prednisolone; Recurrence; Remission, Spontaneous

Topics: Adolescent; Adult; Age Factors; Aged; Central Nervous System Diseases; Child; Child, Preschool; Daunorubicin; Drug Therapy, Combination; Evaluation Studies as Topic; Female; Heart; Heart Diseases; Humans; Infant; Leukemia, Lymphoid; Male; Meninges; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Prognosis; Remission, Spontaneous; Sex Factors; Time Factors; Vincristine

Topics: Child; Cyclophosphamide; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

Topics: Antibody Formation; Drug Therapy, Combination; Evaluation Studies as Topic; Humans; Immunoglobulin G; Immunoglobulin M; Leukemia, Lymphoid; Lymphocytes; Meningitis; Mercaptopurine; Methotrexate; Neoplasm Recurrence, Local; Prednisone; Radiotherapy Dosage; Remission, Spontaneous; Time Factors; Vincristine

Topics: Animals; Antigens, Neoplasm; Drug Resistance; Female; Lymphocytes; Mechlorethamine; Mercaptopurine; Neoplasm Transplantation; Radiation Effects; Rats; Remission, Spontaneous; Sarcoma, Yoshida; Time Factors; Transplantation, Homologous; Tritium

Topics: Adrenal Cortex Hormones; Adult; Antimetabolites; Chronic Disease; Drug Combinations; Humans; Male; Mercaptopurine; Methotrexate; Middle Aged; Psoriasis; Recurrence; Remission, Spontaneous

Topics: Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Nervous System Diseases; Nitrosourea Compounds; Pyrimethamine; Remission, Spontaneous; Time Factors

Topics: Amides; Animals; Antineoplastic Agents; Azacitidine; Cyclic P-Oxides; Cyclophosphamide; Cytarabine; Disease Models, Animal; Drug Combinations; Female; Imidazoles; Lymphoma; Male; Mercaptopurine; Methotrexate; Mice; Mice, Inbred Strains; Oxazines; Prednisone; Remission, Spontaneous; Time Factors; Triazenes; Vincristine

Topics: Antineoplastic Agents; Asparaginase; Cell Division; Chemistry; Culture Techniques; Cytarabine; Daunorubicin; Depression, Chemical; DNA; Drug Combinations; Drug Resistance; Germ-Free Life; Half-Life; History, 20th Century; Hodgkin Disease; Humans; Leukemia; Lymphatic Diseases; Mercaptopurine; Remission, Spontaneous; Stimulation, Chemical; Thioguanine

Topics: Adrenocorticotropic Hormone; Adult; Antibodies; Antilymphocyte Serum; Azathioprine; Cholinesterase Inhibitors; Drug Resistance; Female; Fluorescent Antibody Technique; Humans; Immunity, Cellular; Immunosuppressive Agents; Male; Mercaptopurine; Middle Aged; Muscle Proteins; Myasthenia Gravis; Myosins; Remission, Spontaneous; Thymoma; Thymus Hyperplasia; Thymus Neoplasms

Topics: Adolescent; Adult; Asparaginase; Blood Transfusion; Bone Marrow Transplantation; Child; Cyclophosphamide; Cytarabine; Cytomegalovirus Infections; Daunorubicin; Female; Graft vs Host Reaction; Histocompatibility Testing; Humans; Immunosuppressive Agents; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Vincristine

Topics: Adolescent; Anti-Bacterial Agents; Bone Marrow Cells; Diagnosis, Differential; Hemoglobins; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Leukocyte Count; Male; Mercaptopurine; Prednisone; Prognosis; Remission, Spontaneous; Reticulocytes

Topics: Adolescent; Antineoplastic Agents; Child; Child, Preschool; Cobalt Isotopes; Cytarabine; Female; Humans; Leukemia, Lymphoid; Lymphocyte Activation; Male; Mechlorethamine; Mercaptopurine; Methotrexate; Mitogens; Prednisone; Radiation Effects; Remission, Spontaneous; Thymidine; Time Factors; Tritium; Vincristine

Topics: Cytarabine; Daunorubicin; Evaluation Studies as Topic; Humans; Leukemia, Myeloid, Acute; Mercaptopurine; Prednisone; Remission, Spontaneous

Topics: Asparaginase; Child; Child, Preschool; Drug Synergism; Female; Humans; Infant; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisolone; Remission, Spontaneous; Vincristine

Topics: Adolescent; Adult; Asparaginase; Child; Child, Preschool; Cytarabine; Evaluation Studies as Topic; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Remission, Spontaneous; Vincristine

Topics: Cytarabine; Folic Acid; Humans; Leukemia, Erythroblastic, Acute; Mercaptopurine; Methotrexate; Prednisone; Pyridoxine; Remission, Spontaneous; Vitamin B 12

Topics: Central Nervous System; Child; Cobalt Isotopes; Cyclophosphamide; Humans; Injections, Spinal; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Radioisotope Teletherapy; Remission, Spontaneous; Vincristine

Topics: Adolescent; Cell Transformation, Neoplastic; Child; Child, Preschool; Cyclophosphamide; Humans; In Vitro Techniques; Lectins; Leukemia, Lymphoid; Leukocyte Count; Lymphocytes; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Stimulation, Chemical; Thymidine; Time Factors; Tritium; Vincristine

Topics: Adolescent; Child; Child, Preschool; Daunorubicin; Female; Humans; Infant; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adrenal Cortex Hormones; Bone Marrow; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Mercaptopurine; Methotrexate; Prognosis; Remission, Spontaneous; Time Factors

Topics: Asparaginase; Central Nervous System Diseases; Child; Daunorubicin; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Vincristine

Topics: Acute Disease; Antineoplastic Agents; Cyclophosphamide; Drug Synergism; Humans; Immunotherapy; Leukemia, Lymphoid; Mercaptopurine; Methods; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Vincristine

Topics: Antineoplastic Agents; Central Nervous System; Child; Cyclophosphamide; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Radiation Effects; Radiotherapy Dosage; Remission, Spontaneous; Time Factors; Vincristine

Topics: Age Factors; Antilymphocyte Serum; Antineoplastic Agents; Blood Cell Count; Busulfan; Chlorambucil; Humans; Hydroxyurea; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Prednisone; Prognosis; Remission, Spontaneous

Topics: Adolescent; Anemia, Aplastic; Antineoplastic Agents; Central Nervous System; Child; Child, Preschool; Cyclophosphamide; Daunorubicin; Diarrhea; Drug Combinations; Female; Follow-Up Studies; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Nausea; Pneumonia, Pneumocystis; Prednisone; Radiotherapy; Recurrence; Remission, Spontaneous; Stomatitis, Aphthous; Vincristine; Vomiting

Topics: Adolescent; Bone Marrow Cells; Cells, Cultured; Child; Child, Preschool; Cyclophosphamide; Female; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Lectins; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; T-Lymphocytes; Thymidine; Tritium; Vincristine

Topics: Adjuvants, Immunologic; Asparaginase; Bacterial Vaccines; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Synergism; Female; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Mycobacterium bovis; Prednisone; Remission, Spontaneous; Thioguanine; Vincristine

Topics: Adolescent; Adult; Aged; Antibodies, Antinuclear; Azathioprine; Female; Fluorescent Antibody Technique; Follow-Up Studies; Humans; Lupus Erythematosus, Systemic; Male; Mercaptopurine; Middle Aged; Prednisone; Remission, Spontaneous; Serologic Tests; Sex Factors

Topics: Bone Marrow Examination; Brain Diseases; Central Nervous System Diseases; Cerebrospinal Fluid; Child; Child, Preschool; Female; Humans; Injections, Spinal; Leukemia, Lymphoid; Male; Meninges; Mercaptopurine; Methotrexate; Remission, Spontaneous; Vincristine

Topics: Adolescent; Antibodies; Antibody Formation; Antibody-Producing Cells; Bone Marrow Examination; Child; Child, Preschool; Cyclophosphamide; Female; Humans; Immunodiffusion; Immunoglobulins; Immunologic Memory; Immunosuppression Therapy; Leukemia, Lymphoid; Lymphocytes; Male; Mercaptopurine; Methotrexate; Orthomyxoviridae; Prednisone; Remission, Spontaneous; Vincristine

Topics: Adolescent; Asparaginase; Diabetic Ketoacidosis; Humans; Hyperglycemia; Leukemia; Leukopenia; Male; Mercaptopurine; Prednisone; Remission, Spontaneous

Topics: Adult; Choriocarcinoma; Female; Humans; Hydatidiform Mole; Hysterectomy; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Postoperative Complications; Pregnancy; Remission, Spontaneous; Thoracic Neoplasms; Uterine Neoplasms

Topics: Acute Disease; Adolescent; Adult; Antibiotics, Antineoplastic; Humans; Leukemia; Male; Mercaptopurine; Prednisolone; Recurrence; Remission, Spontaneous

Topics: Acute Disease; Child; Crystallization; Hematuria; Humans; Injections, Intravenous; Kidney; Leukemia; Mercaptopurine; Remission, Spontaneous; Urine

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Age Factors; Aged; Amino Sugars; Antibiotics, Antineoplastic; Antineoplastic Agents; Cytarabine; Drug Synergism; Female; Follow-Up Studies; Glycosides; Humans; Injections, Intravenous; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone; Pregnancy; Remission, Spontaneous; Time Factors

Topics: Adrenocorticotropic Hormone; Azathioprine; Child; Chronic Disease; Cyclophosphamide; Glomerulonephritis; Glucocorticoids; Humans; Immunosuppressive Agents; Long-Term Care; Mercaptopurine; Nephrosis, Lipoid; Nephrotic Syndrome; Prednisone; Remission, Spontaneous; Retrospective Studies

Topics: Acute Disease; Africa, Southern; Asparaginase; Daunorubicin; Europe; Female; Government; History, 18th Century; Hydatidiform Mole; Immunization, Passive; International Cooperation; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Pregnancy; Remission, Spontaneous; Trophoblastic Neoplasms; United States; Vincristine

Topics: Adolescent; Adult; Age Factors; Aged; Amantadine; Asparaginase; BCG Vaccine; Child; Child, Preschool; Cytarabine; Humans; Hydrocortisone; Immunity, Active; Immunization, Passive; Immunotherapy; Infant; Leucovorin; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Middle Aged; Prednisone; Radiotherapy, High-Energy; Remission, Spontaneous; Vincristine

Topics: Adolescent; Agranulocytosis; Candida; Child; Child, Preschool; Enterocolitis, Pseudomembranous; Escherichia coli; Female; Fever; Humans; Infant; Infections; Leukemia; Male; Mercaptopurine; Methotrexate; Mycoses; Pneumonia; Prednisone; Pseudomonas aeruginosa; Remission, Spontaneous; Sepsis; Staphylococcus; Time Factors; Vincristine

Topics: Acute Disease; Autoradiography; Child; Child, Preschool; Female; Humans; Lectins; Leukemia; Lymphocyte Activation; Lymphocytes; Mercaptopurine; Methotrexate; Remission, Spontaneous; RNA; Tritium; Uridine

Topics: Adolescent; Adult; Anti-Bacterial Agents; Blood Platelets; Blood Transfusion; Female; Hemorrhage; Humans; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisolone; Remission, Spontaneous

Topics: Animals; Antibiotics, Antineoplastic; Antineoplastic Agents; Asparaginase; Azaserine; Cyclophosphamide; Cytarabine; Daunorubicin; Female; Fluorouracil; Hydrocarbons, Halogenated; Lymphoma, Non-Hodgkin; Mercaptopurine; Mice; Mice, Inbred Strains; Neoplasm Transplantation; Prednisolone; Remission, Spontaneous; Sarcoma, Experimental; Thiotepa; Time Factors; Triethylenemelamine; Vinblastine; Vincristine

Topics: Adolescent; Adult; Aged; Alopecia; Ampicillin; Anemia, Aplastic; Antibiotics, Antineoplastic; Blood Platelets; Blood Transfusion; Cardiomyopathies; Cephaloridine; Electrocardiography; Female; Heart; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Paresthesia; Remission, Spontaneous; Sulfamethoxazole; Thrombocytopenia; Trimethoprim

Topics: Adolescent; Child; Child, Preschool; Cobalt Isotopes; Cyclophosphamide; Head and Neck Neoplasms; Humans; Leukemia; Lymphoma, Non-Hodgkin; Mediastinal Neoplasms; Mercaptopurine; Methotrexate; Peritoneal Neoplasms; Prednisone; Radioisotope Teletherapy; Remission, Spontaneous; Time Factors; Vincristine

Topics: Adolescent; Adult; Age Factors; Aneuploidy; Bone Marrow Cells; Chromosome Aberrations; Chromosome Disorders; Chromosomes, Human, 13-15; Chromosomes, Human, 16-18; Chromosomes, Human, 21-22 and Y; Chromosomes, Human, 6-12 and X; Cyclophosphamide; Cytarabine; Female; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisone; Recurrence; Remission, Spontaneous; Vincristine

Topics: Adult; Asparaginase; Blood Transfusion; Bone Marrow; Cytarabine; Daunorubicin; Erythrocytes; Erythrocytes, Abnormal; Female; Humans; Iron; Leukemia, Myeloid, Acute; Mercaptopurine; Prednisone; Remission, Spontaneous

Topics: Adolescent; Adult; Antibiotics, Antineoplastic; Antineoplastic Agents; Asparaginase; Azaserine; Child; Child, Preschool; Cytarabine; Female; Glutamine; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Middle Aged; Prednisolone; Remission, Spontaneous; Vincristine

Topics: Adult; Aged; Antibodies; Antigens; Cyclophosphamide; Cytarabine; Female; Hemocyanins; Humans; Hypersensitivity, Delayed; Immunity, Cellular; Immunologic Deficiency Syndromes; Immunosuppression Therapy; Lectins; Leukemia, Myeloid, Acute; Leukocyte Count; Lymphocyte Activation; Lymphocytes; Male; Mercaptopurine; Methotrexate; Prednisone; Prognosis; Remission, Spontaneous; Skin Tests; Thioguanine; Vincristine

Topics: Betamethasone; Bone Marrow Examination; Candidiasis; Daunorubicin; Humans; Leukemia; Leukemia, Myeloid, Acute; Male; Meninges; Meningitis; Mercaptopurine; Methotrexate; Middle Aged; Remission, Spontaneous

Topics: Antineoplastic Agents; Bone Marrow; Child; Child, Preschool; Cytidine; Drug Tolerance; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Leukocyte Count; Leukocytes; Mercaptopurine; Prednisone; Remission, Spontaneous; Thiazines; Vincristine

Topics: Adolescent; Adrenal Cortex Hormones; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Prognosis; Remission, Spontaneous

Topics: Acute Disease; Adolescent; Adult; Aged; Azathioprine; Female; Humans; Infections; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisone; Remission, Spontaneous

Topics: Acute Disease; Adolescent; Adrenal Cortex Hormones; Adult; Age Factors; Aged; Asparaginase; Child; Cyclophosphamide; Cytarabine; Daunorubicin; Humans; Leukemia; Leukemia, Lymphoid; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Mercaptopurine; Methotrexate; Middle Aged; Remission, Spontaneous; Vincristine

Topics: Adolescent; Adult; Aged; Blood Cell Count; Blood Platelets; Bone Marrow Diseases; Busulfan; Child; Cobalt Isotopes; Female; Hemoglobins; Humans; Hydroxyurea; Leukemia, Myeloid; Leukocyte Count; Male; Mercaptopurine; Middle Aged; Radiotherapy; Remission, Spontaneous; Spleen; Time Factors

Topics: Acute Disease; Adolescent; Adult; Aged; Azathioprine; Female; Humans; Infections; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Middle Aged; Prednisone; Remission, Spontaneous

Topics: Acute Disease; Allopurinol; Bone Marrow Examination; Child; Digitalis Glycosides; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Pericardium; Prednisone; Radiography; Remission, Spontaneous; Vincristine

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Antibiotics, Antineoplastic; Antineoplastic Agents; Blood Cell Count; Bone Marrow Examination; DNA, Neoplasm; Drug Synergism; Esterases; Evaluation Studies as Topic; Female; Genetics, Medical; Histocytochemistry; Humans; Leukemia; Male; Mercaptopurine; Middle Aged; Peroxidases; Photometry; Polyploidy; Prednisone; Remission, Spontaneous; Staining and Labeling; Time Factors; Vincristine

Topics: Alkylating Agents; Animals; Antibodies, Viral; Cytarabine; Dactinomycin; Friend murine leukemia virus; Glycine; Leukemia, Experimental; Lymphoma, Large B-Cell, Diffuse; Mercaptopurine; Mice; Mice, Inbred BALB C; Moloney murine leukemia virus; Nitrogen Mustard Compounds; Poly I-C; Porfiromycin; Purines; Pyrans; Rauscher Virus; Remission, Spontaneous; Spleen; Vincristine; Virus Replication

Topics: Adolescent; Animals; Antineoplastic Agents; Asparaginase; Bone Marrow; Bone Marrow Cells; Child; Cytarabine; Daunorubicin; Disease Models, Animal; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Mercaptopurine; Methotrexate; Mice; Remission, Spontaneous; Vincristine

Topics: Adolescent; Angioedema; Daunorubicin; Drug Hypersensitivity; Female; Humans; Leukemia, Lymphoid; Mercaptopurine; Methotrexate; Prednisone; Remission, Spontaneous; Urticaria; Vincristine

Topics: Adult; Aged; Antineoplastic Agents; Bone Marrow Examination; Busulfan; Cytarabine; Female; Humans; Leukemia, Myeloid; Leukocytosis; Male; Mannitol; Mercaptopurine; Middle Aged; Nitrosourea Compounds; Prednisone; Remission, Spontaneous; Splenic Neoplasms; Splenomegaly; Vincristine

Topics: Animals; Autopsy; Child, Preschool; Drug Combinations; Female; Humans; Leukemia; Liver Cirrhosis; Liver Regeneration; Male; Mercaptopurine; Methotrexate; Mice; Mice, Inbred Strains; Remission, Spontaneous