[Etoposide (VP 16/NK 171) and cytosine arabinoside combination chemotherapy in refractory childhood leukemia].

Combination chemotherapy consisting of etoposide and cytosine arabinoside (Ara-C) was given to 38 children with hematological malignancy. They included 18 patients with acute lymphocytic leukemia (ALL), two with non-Hodgkin's lymphoma (NHL), one with myeloproliferative disorder (MPD), and one with histiocytic medullary reticulosis (HMR), all of whom had relapsed or not responded to initial treatment. Sixteen patients with nonlymphocytic leukemia (ANLL), 13 in remission, two in relapse, and one in induction failure, were also studied. The drug combination was administered by intravenous infusion twice a week for two consecutive weeks at a dosage of 150 mg/m2 for each drug. Among the 18 patients with ALL, seven complete responses and three partial responses were achieved. Six of the seven complete responders relapsed at 0.5-3 months, and the remainder has been in remission for 2.5+ months. None of the patients with refractory ANLL, NHL, MPD or HMR achieved complete remission; however, two of three ANLL patients and one HMR patient demonstrated partial response. Among the 13 ANLL patients in remission, 9 patients have continued remission for more than 4 months with a median of 26+ months, ranging from 6+ months to 40+ months, while 4 relapsed within 4 months after the administration of this regimen. The toxic effects were tolerable. Results indicate that an etoposide and Ara-C combination is effective especially in refractory ALL in childhood.