Nine Years' Experience With "Total Therapy" of Childhood Acute Lymphocytic Leukemia

Experience with combined chemotherapy and radiotherapy of acute lymphocytic leukemia (ALL) in children is reviewed. Multiple anti-metabolite chemotherapy is effective in prolonging duration of continuous hematological remission. Craniospinal irradiation or cranial irradiation combined with intrathecal methotrexate in adequate doses inhibits relapse in the central nervous system. The high frequency of lengthy continuous complete remission achieved with "total therapy" indicates that ALL in children cannot be considered an incurable disease. Palliation is no longer an acceptable approach to its initial treatment.