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


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.


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.


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.


Induction/Consolidation with hyper-CVAD in ALL patients was feasible in our institution and had low mortality.

Journal Of Isfahan Medical School, Volume:30 Issue: 193, 2012
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