Second cessation of therapy in childhood lymphocytic leukemia

In an attempt to achieve better estimates of prognosis in children with recurrent acute lymphocytic leukemia, we studied the clinical courses of 17 patients who had relapsed in the bone marrow after elective cessation of therapy and had been treated again with systemic combination chemotherapy without meningeal prophylaxis. Sixteen patients attained second complete remission and were followed for 3-5 yr. Each child relapsed during continuation chemotherapy: 8 in the bone marrow, 6 in the central nervous system. 1 in the testes, and 1 in both the marrow and central nervous system. In 4 of the 7 patients with isolated extramedullary relapse, a new remission was induced. and after 30-44 mo of continuous second bone marrow remission, all therapy was again stopped. Two children remain in remission, off