The treatment of acute lymphoblastic leukemia in children according to BFM protocols

For the past 7 years more than 300 previously untreated patients with ALL admitted to the clinic of our Institute. During the first 3 years 69 patients were treated according to a guideline accepted at that time in all hematological clinics in the USSR. This kind of treatment included standard induction with 2–3 drugs given over 4–6 weeks, then (in some cases) cranial irradiation and prolonged maintenance therapy with 6-MP, Mtx and Cph and reinduction courses every 8–12 weeks during the first 3 years of remission. During induction children received 3–5 intrathecal injections of Mtx or Mtx + Ara-C; doses were counted according to body surface. It was hardly a programmed therapy because it was not strictly identical for specific risk groups, the doses and the time schedule were varied arbitrary and supportive care wasn’t adequate. The results of such kind of treatment were by no means satisfactory with high frequency of relapses; the rate of continuous complete remissions was not more than 40% (Rumjantsev, 1980). So the results were comparable with those major centers abroad had achieved at the beginning of the 70’s (Pinkel et al, 1971).