Vcr induced complete marrow remission in 43% of children with all types of acute leukemia who were refractory to other antileukemic therapy. The median duration of disease before Vcr treatment was 13.5 months. The marrow response in those patients achieving an A marrow was rapid with a marked clearing of the blasts by 14 days and a complete remission by 28 days. The median duration of complete remission with and without maintenance therapy was 63.5 and 59 days, respectively.
Drug toxicity occurred in about half the patients, limiting the total dose of drug that could be given. Leukopenia, alopecia, gastrointestinal symptoms, and neurotoxicity were the most common problems seen. These were reversible on withdrawal of the drug.
Remissions were not improved by increasing the dose of Vcr to 0.1 mg/kg for two or more doses after 4 doses of 0.075 mg/kg. The reduction in dose necessitated by drug toxicity was not detrimental to a good response since the children attaining complete remissions experienced the greatest number of alterations in dose prior to the onset of remission.
Oral manifestations of acute leukemia in children: family supernatural beliefs and its contribution to the prognosis of the disease
