Background: Although improvement in the management of adult acute Iymphocytic leukemia(ALL) has not been as rapid as in the childhood form of this disease, progress
has been achieved in remission induction rate and increased in survival.
Methods: Twenty previously untreated patients with ALL were treated with induction chemotherapy consisting of vincristine, prednisolone, daunorubicin, and
L-asparaginane. After successful remission induction, postremission therapy was performed with CNS prophylaxis(cranial irradiation and intrathecal methotrexate) and
maintenance chemotherapy (methotrexate and 6-mercaptopurine).
Results:
1) Seventeen out of twenty(85%) cases achieved complete remission. The median duration of remission and overall survival were 14.5 months(4-50 months) and 13mon1hs(1-15 months) respectively.
2) Three-year remission rate was 25% in CR patients, and 3-year survival rate was 21.1% in overall patients.
3) Two patients were refractory to induction chemotherapy, and one died from complication during induction therapy. Fifteen (88.2%) out of seventeen patients who had
achieved remission relapsed, and the sites of relapse were the bone marrow (80%), CNS(13.3%), and both(6.7%).
4) The median nadir of WBC and platelet were 600/㎣(200-1,400/㎣) and 18,000 /㎣(1,000-87,000/㎣) during induction chemotherapy, and the median duration of the marrow
recovery was 20 days(14-60 days).
5) Non-hematologic toxicities were nausea(100%), vomiting(100%), alopecia(100%), stomatitis(60%), diarrhea(45%), hepatotoxicity(40%), neurotoxicity(20%), nephrotoxicity(5%), and increased amylase level(5%).
Conclusion: These data suggest that combination chemotherapy consisting of vincristine, prednisolone, daunorubicln, and L-asparaginase in adult ALL was useful to
remission induction. In the future, intensive postremission therapy should be considered to increase survival duration.

Keywords: Acute Iymphocytic leukemla, Combination chemotherapy,