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Chemotherapy for Initial Induction Failures in Childhood Acute Lymphoblastic Leukemia: A Children’s Oncology Group Study (POG 8764)

Joyce, Michael J. MD; Pollock, Brad H. PhD; Devidas, Meenakshi PhD; Buchanan, George R. MD; Camitta, Bruce MD

Journal of Pediatric Hematology/Oncology: January 2013 - Volume 35 - Issue 1 - p 32–35
doi: 10.1097/MPH.0b013e318279afdd
Original Articles

Children with acute lymphocytic leukemia who fail to enter remission have a poor prognosis. In a previous study, 9 of 14 children with induction failure entered remission after teniposide (VM26) plus cytosine arabinoside (Ara-C). We attempted to confirm these results. Twenty children received teniposide (200 mg/m2/day IV) for 3 days and cytosine arabinoside (100 mg/m2/day continuous IV infusion) for 7 days. There were 3 complete and 3 partial responses. Two additional patients achieved a complete response after a second, shorter course of the same agents. Although VM26 plus Ara-C is an active combination for treatment of acute lymphocytic leukemia induction failure, it does not appear as effective as in the initial report. Better treatments for this problem are needed.

*Nemours Children’s Clinic, Jacksonville, FL

Department of Epidemiology and Biostatistics, the Cancer Therapy and Research Center, University of Texas Health Sciences Center, San Antonio

§University of Texas Southwestern Medical Center, Dallas, TX

Department of Biostatistics, College of Public Health and Health Professions, the Children’s Oncology Group, University of Florida Gainesville, FL

MACC Fund Center for Cancer and Blood Disorders, Medical College of Wisconsin, Children’s Hospital of Wisconsin, Milwaukee, WI

The authors declare no conflict of interest.

Reprints: Bruce Camitta, MD, MACC Fund Center for Cancer and Blood Disorders, 8701 Watertown Plank Road, Milwaukee, WI 53226 (e-mail:

Received October 18, 2011

Accepted March 27, 2012

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