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November 27, 1972

Combination Chemotherapy of Acute Leukemia and Hodgkin's Disease

Author Affiliations

From the Children's Cancer Research Foundation, Charles A. Dana Cancer Center, and Harvard Medical School, Boston.

JAMA. 1972;222(9):1168. doi:10.1001/jama.1972.03210090048020

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The best single agent for the treatment of acute leukemia in adults is cytarabine hydrochloride. Intermittent treatment with this agent is superior to daily treatment in experimental systems. A quantitative study was performed in 136 adults with acute leukemia wherein patients were randomly allocated to two treatments: (1) five-day courses of intravenous administration at 150 mg/sq m/day every two to three weeks, and (2) two-day courses of intravenous administration at a dose of 400 mg/sq m/day every two weeks. The five-day course resulted in a 38% complete remission rate which was significantly superior to the two-day course. In pilot studies, the tolerated doses of five days of cytarabine hydrochloride in combination with cyclophosphamide and subsequently with cyclophosphamide, vincristine, and prednisone (the COAP program) were established. Following this, a quantitative study was performed in 121 patients comparing five-day courses of cytarabine hydrochloride with five-day courses of COAP. Courses were given every