Remission induction phase

remission induction phase

The aim of induction treatment is to eliminate more than 99% of the initial burden of leukaemic cells and also to restore normal haemotopoiesis and healthy performance status.

Drugs used in remission-induction treatment include:

• a glucocorticoid (prednisone or dexamethasone),
• vincristine,
• asparaginase
• anthracycline (1)

For the standard risk cases (on the basis that they receive intensified post-remission treatment) the three drug induction regimen is considered to be effective.

For Children with high-risk or very high-risk ALL and nearly all adult cases with ALL, four or more drugs are used for remission induction (1).

No induction therapy has been shown to be superior to the other, however:

• in T cell ALL, addition of cyclophosphamide and intensive treatment with asparaginase have been shown to be beneficial
• the use of imatinib mesylate has resulted in an increase in the remission-induction rate, duration of disease-free survival, and quality of life of patients with Philadelphia chromosome-positive ALL

Reference:

• 1. Pui CH, Robison LL, Look AT. Acute lymphoblastic leukaemia. Lancet. 2008;371(9617):1030-43.