MOAD THERAPY FOR ADULT ACUTE LYMPHOCYTIC LEUKEMIA (ALL) (MEETING ABSTRACT)

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

MOAD THERAPY FOR ADULT ACUTE LYMPHOCYTIC LEUKEMIA (ALL) (MEETING ABSTRACT)

Haematologica; 76(Suppl 4):66 1991. Unique Identifier : AIDSLINE ICDB/92680563
Dutcher JP; Wiernik PH; Gucalp R; Markus S; Esterhay R; Paietta E; Benson L; Azar C; Albert Einstein Cancer Center, 1300 Morris Park Ave., New York,; NY 10461

Abstract: 54 previously untreated adult (greater than or equal to 15 yr) patients (pts) with ALL were treated with MOAD (intensive 4-phase program of methotrexate [mtx], vincristine, L-asparaginase [L-asp], dexamethasone). The initial 24 pts were treated with iv L-asp and the last 30 pts with im L-asp to abrogate anaphylactic reactions which limited therapy in 50% of the first group. Cytoreduction/CNS prophylaxis was with high dose mtx (Blood 70:241a, 1987). Pts included 31 males and 23 females, median age 38 yr (range 15-73 yr), median WBC 8 x 10(30)/ul (range 0.8-400), median blast count 40% (range 0-96%), median platelet count 75 x 10(3)/ul (range 3-300). All pts were Tdt+. In the latter 30 pts, 14/26 tested were CALLA+. Induction/consolidation toxicity was hematologic: WBC less than 1000/ul, platelets less than 20,000/ul in 80% of pts, but was minimal during post CR therapy. Infection during induction occurred in 35 pts, with 14 severe. Five infectious deaths occurred in CR, three bacterial, one Candida and one Pneumocystis (HIV+ pt). One pt died in CR during BMT at 25+ mo. Aseptic necrosis of hips has occurred in 3 long-term remitters. 41/52 evaluable pts achieved CR (79%), median duration 12 mo (range 0.5-180+ mo), with 25% of pts alive in CR greater than or equal to 5 yr. Four pts developed CNS leukemia while in marrow CR, two with concurrent marrow relapse. The other two remain in 1st marrow and 2nd CNS CR at 74+ and 174+ mo. MOAD, without anthracycline, is relatively nontoxic and yields a high remission rate with durable remissions in 25% of adult pts with ALL.

Keywords: Adolescence Adult Aged Antineoplastic Agents, Combined/*THERAPEUTIC USE Asparaginase/ADMINISTRATION & DOSAGE Dexamethasone/ADMINISTRATION & DOSAGE Female Human Infection/COMPLICATIONS Leukemia, Lymphocytic, Acute, L2/COMPLICATIONS/*DRUG THERAPY Male Methotrexate/ADMINISTRATION & DOSAGE Middle Age Vincristine/ADMINISTRATION & DOSAGE CLINICAL TRIAL ABSTRACT
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