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Remission induction and remission maintenance in adult acute nonlymphocytic leukemia employing a modified cytostatic (COAP) regimen

Remissionsinduktion und -erhaltung bei Erwachsenen mit akuter, nicht lymphozytärer Leukämie mittels modifiziertem COAP-Schema

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Zusammenfassung

Dreißig Erwachsene mit akuter, nicht lymphozytärer Leukämie (ANLL) wurden mit einem modifizierten COAP-Schema behandelt. Vincristin, Cyclophosphamid und Prednison wurden i. v. injiziert, während der Antimetabolit Cytosin-Arabinosid in Form 8stündiger Dauerinfusionen appliziert wurde. Neunzehn Patienten (63%) erreichten eine komplette Remission. Die Remissionserhaltung bestand in oraler Gabe von 6-Mercaptopurin täglich und Amethopterin zweimal wöchentlich. Im Laufe der Studie wurde die Erhaltungstherapie durch COAP-Konsolidierung und COAP-Reinduktionsbehandlungen ergänzt. Dadurch konnte die mediane Remissionsdauer von 7 auf 24 Monate verbessert werden. Ein Vergleich dieser Ergebnisse mit der Literatur zeigt, daß das modifizierte COAP-Schema zu den wirkungsvollsten Behandlungsverfahren bei akuter Leukämie im Erwachsenenalter gehört.

Summary

Thirty adult patients suffering from acute nonlymphocytic leukemia (ANLL) were treated according to a modified COAP regimen. Vincristine, cyclophosphamide, and prednisone were given by push injection, while cytosine arabinoside was infused over periods of 8 h. Nineteen patients (63%) achieved complete remission. Remission maintenance therapy consisted of 6-mercaptopurine daily and methotrexate twice weekly. Later in the study, COAP consolidation and reinduction was added, which improved the median duration of complete remission from 7 to 24 months. Comparison of the results with the literature shows that the modified COAP regimen is one of the most effective treatment schedules for adult ANLL.

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  1. Medizinische Universitätsklinik Köln, Joseph-Stelzmann-Straße 9, D-5000, Köln 41, Germany

    D. Gerecke, W. D. Hirschmann, R. Voigtmann & R. Gross

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  1. D. Gerecke
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  2. W. D. Hirschmann
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  3. R. Voigtmann
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  4. R. Gross
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Gerecke, D., Hirschmann, W.D., Voigtmann, R. et al. Remission induction and remission maintenance in adult acute nonlymphocytic leukemia employing a modified cytostatic (COAP) regimen. Blut 39, 39–45 (1979). https://doi.org/10.1007/BF01008073

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