EurekaMag.com logo
+ Site Statistics
References:
53,623,987
Abstracts:
29,492,080
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Treatment of adult acute lymphocytic leukemia with Hyper-CVAD Experience in a county teaching hospital



Treatment of adult acute lymphocytic leukemia with Hyper-CVAD Experience in a county teaching hospital



Blood 96(11 Part 2): 213b, November 16



Purpose: To report the experience in Ben Taub General Hospital, a county teaching hospital, in treating adult acute lymphocytic leukemia (ALL) with Hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone). Patients and Methods: Between June 1994 and January 2000, 26 adults with newly diagnosed ALL presented to Ben Taub General Hospital in Houston, TX. All patients were treated with Hyper-CVAD. No exclusions were made because of age, performance status, or other medical problems. Median age was 25.5 years; 2 patients (8%) were 50 years or older. T-cell disease was present in 4 (15%); none had mature B-cell disease. Philadelphia chromosome-positive disease was present in 5 (19%). Leukocytosis of more than 30 X 109 was found in 9 (35%), CNS leukemia at diagnosis in 3 (12%), and a mediastinal mass in 2 (8%). Treatment consisted of four cycles of Hyper-CVAD alternating with four cycles of methotrexate and cytarabine. All patients received intrathecal CNS prophylaxis, antibiotic prophylaxis, and granulocyte-colony stimulating factor support. All patients were treated on schedule and at full doses, except one case in which the vincristine was held during courses 3, 5, and 7 due to severe neuropathy. Maintenance therapy consisted of two years of treatment with mercaptopurine, methotrexate, vincristine, and prednisone (POMP). Results: Of the 26 patients, 20 (77%) achieved a complete remission, 2 (8%) died during induction therapy, and 4 (15%) never achieved remission. After a median follow-up time of 20 months (range 1 - 59 mo.), 8 (31%) are still alive, 7 of them in first CR, and one with relapse of disease. Of the 13 patients who relapsed, there was only 1 with relapse in the CNS, 1 with testicular relapse, while the remainder were leukemic relapses. Median survival was 11 months, with an estimated 2-year survival of 40% (standard error 10%). Conclusions: 1- The Hyper-CVAD regimen is effective, and can be safely given in a county hospital setting. 2- The Hyper-CVAD regimen was effective in preventing CNS relapse. 3- The Hyper-CVAD regimen may be particularly effective for T cell ALL. 4- The efficacy was significantly lower than expected compared to prior single-institution reports, despite strict adherence to the treatment schedule. 5- As the presenting characteristics of our patients were very similar to those of other series reported, it is imperative that other factors, such as ethnic background and the biology of the disease itself, be explored as possible causes for this difference in outcome.

(PDF 0-2 workdays service: $29.90)

Accession: 035980844

Download citation: RISBibTeXText



Related references

Results of treatment with hyper-CVAD, a dose-intensive regimen, in adult acute lymphocytic leukemia. Journal of Clinical Oncology 18(3): 547-561, 2000

The hyper-CVAD regimen in adult acute lymphocytic leukemia. Hematology/Oncology Clinics of North America 14(6): 1381-96, X-Xi, 2001

Modified Burkitt regimen for adult acute lymphocytic leukemia The hyper-CVAD program. Blood 82(10 SUPPL 1): 329A, 1993

Modified Burkitt therapy in adult acute lymphocytic leukemia The hyper-CVAD regimen. Annals of Hematology 68(2): A10, 1994

Update of the hyper-CVAD dose-intensive regimen in adult acute lymphocytic leukemia. Blood 92(10 SUPPL 1 PART 1-2): 313A, Nov 15, 1998

Update of the hyper-CVAD program in newly-diagnosed adult acute lymphocytic leukemia. Blood 86(10 SUPPL 1): 173A, 1995

Update of the modified hyper-CVAD regimen in newly diagnosed adult acute lymphocytic leukemia. Blood 102(11): 880a, November 16, 2003

Outcome of treatment with Hyper-CVAD regimen in Chinese patients with acute lymphocytic leukemia. Leukemia Research 32(6): 930-935, 2007

Treatment of Philadelphia chromosome-positive acute lymphocytic leukemia with hyper-CVAD and imatinib mesylate. Blood 103(12): 4396-4407, 2003

Long-term follow-up results of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper-CVAD), a dose-intensive regimen, in adult acute lymphocytic leukemia. Cancer 101(12): 2788-2801, 2004

Single centre experience with the Hyper-CVAD regimen in adult acute lymphoblastic leukemia Preliminary analysis of efficacy and toxicity. Blood 98(11 Part 2): 216b, November 16, 2001

Comparison of two different schedules of granulocyte-colony-stimulating factor during treatment for acute lymphocytic leukemia with a hyper-CVAD (cyclophosphamide, doxorubicin, vincristine, and dexamethasone) regimen. Cancer 94(2): 285-291, 2002

Comparison of the Hyper-CVAD with an institutional regimen for the treatment of acute lymphoblastic leukemia in adults in a hospital of Mexico. Revista Peruana de Medicina Experimental Y Salud Publica 31(3): 525-529, 2014

Treatment of Adult Acute Lymphoblastic Leukemia with the Hyper-CVAD Regimen Preliminary Analysis from a Single Center. Blood 100(11): Abstract No 4617, November 16, 2002

Clinical characteristics and treatment outcome of adult acute lymphoblastic leukemia with t(4;11)(q21;q23) using a modified hyper-CVAD regimen. Acta Haematologica 122(1): 23-26, 2009