Chemotherapy of Acute Leukemia: Comparison of Cytarabine Alone and in Combination With Vincristine, Prednisone, and Cyclophosphamide

A regimen consisting of vincristine sulfate, prednisone, cytarabine, and cyclophosphamide (COAP) has been compared with cytarabine alone in a study of 123 patients with acute leukemia. Of the 66 patients receiving the COAP regimen, 32 achieved complete remission compared to 18 of the 57 patients who received cytarabine alone. The complete remission rates for patients receiving an adequate trial of chemotherapy were 74% and 49%, respectively. The median duration of complete remission was 62 weeks for patients receiving the COAP regimen and 46 weeks for patients receiving cytarabine alone. The median duration of survival for all patients entered on therapy was 35 weeks for the COAP regimen and 8 weeks for cytarabine alone. The COAP regimen is effective and safe for adults with acute leukemia and is probably superior to cytarabine alone, especially in patients who are more than 35 years. old.