Evaluating the Feasibility of Prescribing Hyper-CVAD Regimen in Adult Acute Lymphoblastic Leukemia

Abstract

Background: Hyper cyclophosphamide, vincristine, Adriamycin, and dexamethasone (CVAD) regimen is considered as an effective regimen in treatment of adult acute lymphoblastic leukemia (ALL), with complete remission (CR) rate of 90% in previous studies. The aim of this research was to evaluate the feasibility of this regimen in ALL patients in Seyed-Al-Shohada Hospital, Isfahan, Iran. Methods: Eleven adults with newly diagnosed ALL received therapy with hyper-CVAD regimen consisting of 8 courses of alternative intensive chemotherapy with growth factor support and intrathecal chemotherapy prophylaxis followed by oral maintenance chemotherapy. CR was evaluated 2 and 4 weeks after the first courses of chemotherapy. Findings: The mean age of patients was 25 years. After the first course of treatment, 9 patients (82%) achieved CR while 2 patients (18%) relapsed. Overall survival (OS) at 6 and 12 months was 91% and 81%, respectively. Disease free survival (DFS) at 6 and 12 months was 91% and 60% respectively. Febrile neutropenia was seen in 88% of patients in Induction. No death was seen in Induction. Conclusion: Induction/Consolidation with hyper-CVAD in ALL patients was feasible in our institution and had low mortality. Keywords: Acute lymphoblastic leukemia, Hyper-CVAD regimen, Remission Induction