Childhood acute lymphoblastic leukemia in the Netherlands - Randomized studies and nationwide treatment results from 1972 to 1995

The Dutch Childhood Leukemia Study Group (DCLSG) has implemented eight protocols for the treatment of childhood acute lymphoblastic leukemia (ALL) (ALL I to VIII) during the period from 1972 to 1995. They were based on St. Jude's Total Therapy (ALL II to VI) and the risk-adapted intensive therapy (ALL VII and VIII) developed by the BFM Group, respectively, and included seven randomized studies. In study ALT, I (N = 43, 1972 to 1973), no effect was observed after the addition of daunorubicin to vincristine/prednisone pulses during maintenance treatment. In study ALL II (N = 143, 1973 to 1975) the addition of cyclophosphamide to maintenance treatment with 6-mercaptopurine/methotrexate increased toxicity and mortality without increasing the event-free survival rate. In study ALL III (N = 148; 1975 to 1979) for non-high-risk patients (defined as initial leukocyte coun