PURPOSE: To assess the efficacy and @entity137 of a new treatment program of intensified and shortened cyclical chemotherapy (protocol 8707) in adults with @entity981 ( @entity981 ). @entity1 AND METHODS: Previously untreated adults < or = 60 years old with @entity981 were treated with a four-agent induction chemotherapy regimen. This was followed by cyclical postremission therapy with high-dose @entity2592 / @entity2879 ; high-dose @entity1499 / @entity4446 ; and @entity5699 , @entity1891 , @entity229 , and asparaginase. Maintenance chemotherapy with oral @entity1499 and @entity4446 was continued for 30 months. CNS prophylaxis was given with intrathecal @entity1499 in addition to the systemic chemotherapy indicated above. RESULTS: Seventy-eight of 84 @entity1 (93%) achieved complete remission. With a median follow-up of 5.6 years, 5-year event-free survival (EFS) of all remission @entity1 is 52%. @entity1 with high-risk features including adverse cytogenetics, failure to achieve remission with the first cycle of chemotherapy, and B-precursor disease with WBC counts more than 100,000/microL all relapsed unless taken off study for transplantation. For @entity1 without these high-risk features, 5-year EFS was 60%. Compared with our previous treatment regimen, results appear to be improved for @entity1 with standard-risk B-precursor disease (5-year EFS, 66% v 34%; P =.01). CONCLUSION: Intensified and shortened chemotherapy may improve the outcome for @entity1 with @entity981 with B-precursor disease lacking high-risk features. Further trials of this regimen are warranted.

Intensified and shortened cyclical chemotherapy for adult XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'PATIENTS'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity981 :: ('MESH:D054198', 'Disease') :: ['ALL', 'acute lymphoblastic leukemia'] @entity5699 :: ('MESH:D003630', 'Chemical') :: ['daunorubicin'] @entity229 :: ('MESH:D011241', 'Chemical') :: ['prednisone'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity2592 :: ('MESH:D003561', 'Chemical') :: ['cytarabine'] @entity4446 :: ('MESH:D015122', 'Chemical') :: ['6-mercaptopurine'] @entity1891 :: ('MESH:D014750', 'Chemical') :: ['vincristine'] @entity1499 :: ('MESH:D008727', 'Chemical') :: ['methotrexate']
@entity981 :: (MESH:D054198,Disease) :: ['acute lymphoblastic leukemia']
