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L-Asparaginase, Vincristine, and Prednisone for Induction of First Remission in Acute Lymphocytic Leukemia¹

Department of Pediatrics, University of Southern California School of Medicine, and Division of Hematology-Oncology [J. A. O., M. K., D. H.] and Radiotherapy [R. E. H.], Childrens Hospital of Los Angeles, Los Angeles, California 90054; Division of Pediatric Hematology-Oncology, University of Minnesota, Minneapolis, Minnesota 55455 [M. E. N.]; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104 [M. H. D.]; and Department of Medicine, University of Southern California School of Medicine, Los Angeles, California 90033 [J. W.]

L-Asparaginase was added to vincristine and prednisone for induction of first remission in 815 children with acute lymphocytic or acute undifferentiated leukemia. This combination resulted in an overall remission rate of 93%. The addition of L-asparaginase to the standard induction regimen using prednisone and vincristine did not significantly increase the morbidity or mortality rate during the induction period. The most common side effect was transient L-asparaginase-induced hyperglycemia. The safe administration of L-asparaginase i.m. and the dose efficacy of 6000 I.U./sq m were confirmed. For these reasons, L-asparaginase should be combined with vincristine and prednisone for the initial induction of children with acute lymphocytic or acute undifferentiated leukemia.

¹ Presented in part at the 66th Annual Meeting of the American Association for Cancer Research, San Diego, Calif., May 7 to 11, 1976 (11). Investigators, institutions, and grant support are given in the "Appendix."

² To whom requests for reprints should be addressed.

Received 5/26/76. Accepted 11/ 9/76.

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