Papers And Originals


Br Med J 1971; 4 doi: (Published 23 October 1971) Cite this as: Br Med J 1971;4:189


One hundred and ninety-one cases of acute lymphoblastic leukaemia were entered in a trial in which, for five months, all received cytotoxic therapy with prednisolone, vincristine, mercaptopurine, L-asparaginase, and methotrexate (the latter in high dosage followed by folinic acid). Patients were then randomized to receive immunotherapy (B.C.G.), twice-weekly methotrexate, or no further treatment.

One hundred and seventy-seven patients (93%) achieved full remission and at the time of analysis, 26 months from the beginning of the trial, 143 were still alive, including 70 in their first remission. Median “post-intensive” remission lengths were 17 weeks (no treatment), 27 weeks (B.C.G.), and 52 weeks (methotrexate). The prolongation of remission by methotrexate was most evident in those patients with low initial white cell counts. B.C.G. seemed to cause lymphocytosis but was without other conspicuous effect. The incidence of toxic reactions is reported, including an unusually low rate of anaphylaxis with L-asparaginase.

These preliminary results are discussed and compared with those of similar trials.


  • * The members of the Working Party were: Professor J. H. Hutchison (chairman), Professor R. M. Hardisty (secretary), Dr. K. D. Bagshawe, Dr. J. M. Bridges, Dr. D. I. K. Evans, Dr. D. A. G. Galton, Dr. R. J. Guyer, Dr. F. Harris, Dr. C. B. Howarth, Dr. E. M. Innes, Dr. H. W. Everley Jones, Dr. P. Morris Jones, Dr. H. E. M. Kay, Dr. D. Mainwaring, Dr. J. Martin, Mr. R. Peto, Dr. M. G. Philpott, Dr. M. C. Pike, Dr. L. S. Sacker, Dr. W. H. Schutt, Dr. J. Stuart, Dr. E. Thompson, Dr. M. M. Till, and Dr. M. L. N. Willoughby.

    Additional patients were submitted by: Dr. S. Callender, Dr. G. Hamilton Fairley, Professor F. G. J. Hayhoe, Professor M. C. G. Israëls, Professor A. Jacobs, Dr. G. A. McDonald, Squadron Leader C. R. Newman, R.A.F., Dr. C. D. R. Pengelly, and Dr. D. J. Weatherall.

    Professor L. J. Witts, chairman of the Leukaemia Committee, and Professor J. V. Dacie, chairman of the Working Party on Leukaemia in Adults, took part in the planning and supervision of the trial.

    The data were collected together by Dr. N. B. Ikoku and Miss M. Gilham at the Leukaemia Trials Office, Royal Marsden Hospital, under the supervision of Dr. H. E. M. Kay. This report was drafted by Dr. Kay. Statistical analysis was carried out by Mr. Peto and Dr. Pike.