RESUMO
Objective To investigate the efficacy of modified VDLP (vincristine + daunorubicin + L-asparaginase + prednisone) for acute lymphoblastic leukemia (ALL) in elderly patients and its adverse reactions.Methods 31 elderly patients diagnosed as ALL at the initial visit from Jan.2009 to Dec.2014 were randomly divided into the experiment group (n=16) and the control group (n=15).Patients in the control group received traditional VDLP chemotherapy (vincristine 2 mg at 1,8,15 days;daunorubicin 30-40 mg/m2 at 1,2,15,16 days;L-asparaginase 6 000-10 000 U at 11,14,17,20 days;prednisone 1 mg/kg at 1 to 14 days),whereafter underwent a gradual dose reduction and drug withdrawal within 1-2 weeks.Patients in the experiment group received the modified VDLP chemotherapy (vincristine 2mg at 1,8,15 days;daunorubicin 30-40 mg/m2 at 1-3 days;L-asparaginase 6 000-10 000 U at 11,14,17,20 days;prednisone 1 mg/kg at 1 to 14 days),whereafter underwent a gradual dose reduction and drug withdrawal within 1-2 weeks.The complete response (CR) rate and complications were recorded.Results The CR rates were 53.3％ in modified VDLP group and 58.3％ in VDLP group,and there was no statistically significant difference between two groups (P ＞ 0.05).The treatment-related mortality and the incidence of severe infection had significant differences between the modified VDLP and VDLP groups (6.3％ vs.46.3％,31.3％ vs.66.7％,both P＜0.05).Conclusions Compared with VDLP,the modified VDLP is more tolerable and suitable for the elderly patients with ALL.