Intrathecal chemotherapy in Burkitt's lymphoma

Meningeal involvement with Burkitt lymphoma cells constitutes the most challenging therapeutic problem in the management of Burkitt's tumour. The results of intrathecal chemotherapy with methotrexate or cytosine arabinoside in 55 episodes of malignant pleocytosis in 38 patients with Burkitt's tumour are described. The response was complete in nearly all patients after the administration of either agent. Cerebrospinal fluid (C.S.F.) remissions were more prolonged in patients receiving intrathecal methotrexate or cytosine arabinoside daily for four days as opposed to a 10-day schedule. A controlled randomized trial of "prophylactic" intrathecal chemotherapy in patients without malignant cells in the C.S.F. on admission showed no protective effect against the subsequent development of malignant pleocytosis. Future therapeutic approaches are considered in the light of these results.

Combination chemotherapy in acute myeloblastic leukemia

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Combination chemotherapy using L-asparaginase, daunorubicin, and cytosine arabinoside in adults with acute myelogenous leukaemia

Cytosine arabinoside and daunorubicin used in an intensive intermittent regimen have been shown to be an effective combination for the induction of complete remissions in 14 out of 23 adult patients with acute myelogenous leukaemia. This gives an overall complete remission rate of 60%. A further patient had a good partial remission. The addition of L-asparaginase to the regimen has not increased the incidence of remission and there were more side effects in the L-asparaginasetreated group. Of the 10 patients treated with L-asparaginase in addition to cytosine arabinoside and daunorubicin, five achieved a complete remission. Of the 13 patients treated with cytosine arabinoside and daunorubicin without L-asparaginase, nine achieved a complete remission and one a good partial remission.

Remission induction with cytosine arabinoside and L-asparaginase in acute lymphoblastic leukaemia

Nine patients with acute lymphoblastic leukaemia in relapse were treated with a course of cytosine arabinoside followed immediately by a course of L-asparaginase. Eight patients achieved complete remission of their disease. This combination of drugs is sufficiently effective to suggest that further trial is needed. It is possible that the combination has a synergistic effect.