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Combination chemotherapy for children with acute lymphocytic leukemia who fail to respond to standard remission‐induction therapy

Short courses of cytosine arabinoside (Ara‐C), cyclophosphamide, and L‐asparaginase were given to seven children with newly diagnosed acute lymphocytic leukemia, who had failed to remit on standard remission induction therapy. These 4‐day courses of Ara‐C and cyclophosphamide followed by 4 days of L‐asparaginase were repeated at 3‐ to 4‐week intervals for two to four courses. Complete remision occurred in six patients. The median duration of remission was 94+ days, on various maintenance regimens. The most serious side effect was neutropenia. This combination of these three drugs appears to be effective remission‐induction therapy for children with ALL with unfavorable prognostic features.