{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:08:16Z","timestamp":1791259696718,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2004,10,12]],"date-time":"2004-10-12T00:00:00Z","timestamp":1097539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2004,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Modern intensive chemotherapy regimens have improved the prognosis for patients with adult acute lymphocytic leukemia (ALL). With these regimens, the complete response rates are now reported to be &gt; 80%, and the long\u2010term survival rates range from 30% to 45%. The current analysis updated the long\u2010term results with the original hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper\u2010CVAD) program, with a median follow\u2010up time of 63 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Between 1992 and 2000, 288 patients were treated with Hyper\u2010CVAD. The median age of the patients was 40 years, and 59 patients (20%) were \u2265 age 60 years. The incidence of Philadelphia chromosome (Ph)\u2010positive ALL was 17%, and the incidence of of T\u2010cell ALL was 13%.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A complete response (CR) was achieved in 92% of patients. The induction mortality rate was 5% (2% if the patient's age was &lt; 60 years, and 15% if the patient's age was \u2265 60 years). With a median follow\u2010up time of 63 months, the 5\u2010year survival rate was 38% and the 5\u2010year CR duration rate was 38%. Multivariate analysis of prognostic factors for CR duration identified the following adverse factors: age \u2265 45 years, leukocytosis \u2265 50 \u00d7 10<jats:sup>9<\/jats:sup>\/L, poor performance status (an Eastern Cooperative Oncology Group score of 3\u20134), Ph\u2010positive disease, French\u2013American\u2013British L2 morphology, &gt; 1 course to achieve CR, and Day 14 bone marrow blasts &gt; 5%. Patients were divided into low\u2010risk (risk score 0\u20131; 37%), intermediate risk (risk score 2\u20133; 36%), and poor\u2010risk groups (risk score \u2265 4; 27%) with 5\u2010year CR duration rates of 52%, 37%, and 10%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Compared with the previous VAD regimens, Hyper\u2010CVAD was associated with significantly better CR rates, CR duration, and survival. The long\u2010term follow\u2010up results of Hyper\u2010CVAD were favorable. Comparison of Hyper\u2010CVAD with other established adult ALL regimens is warranted. Cancer 2004. \u00a9 2004 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.20668","type":"journal-article","created":{"date-parts":[[2004,10,12]],"date-time":"2004-10-12T17:01:48Z","timestamp":1097600508000},"page":"2788-2801","source":"Crossref","is-referenced-by-count":568,"title":["Long\u2010term follow\u2010up results of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (Hyper\u2010CVAD), a dose\u2010intensive regimen, in adult acute lymphocytic leukemia"],"prefix":"10.1002","volume":"101","author":[{"given":"Hagop","family":"Kantarjian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"O'Brien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Cortes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Giles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sima","family":"Jeha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos E.","family":"Bueso\u2010Ramos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Pierce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqin","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Koller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miloslav","family":"Beran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Keating","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil J.","family":"Freireich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,12]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11664"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(05)70188-X"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(05)70189-1"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(05)70190-8"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(05)70191-X"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(05)70192-1"},{"key":"e_1_2_5_8_2","doi-asserted-by":"crossref","first-page":"2814","DOI":"10.1182\/blood.V78.11.2814.2814","article-title":"Treatment of adult acute lymphoblastic leukemia with intensive cyclical chemotherapy: a follow\u2010up report","volume":"78","author":"Linker CA","year":"1991","journal-title":"Blood."},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.3.547"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-0734.2002.00066.x"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-08-2958"},{"key":"e_1_2_5_12_2","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1200\/JCO.1990.8.6.994","article-title":"Results of the vincristine, doxorubicin and dexamethasone regimen in adults with standard\u2010 and high\u2010risk acute lymphocytic leukemia","volume":"8","author":"Kantarjian HM","year":"1990","journal-title":"J Clin Oncol."},{"key":"e_1_2_5_13_2","first-page":"3983","article-title":"Prospective karyotype analysis in adult acute lymphoblastic leukemia: the Cancer and Leukemia Group B experience","volume":"93","author":"Wetzler M","year":"1999","journal-title":"Blood."},{"key":"e_1_2_5_14_2","first-page":"856a","article-title":"Allogeneic transplant (related or unrelated donor) is the preferred treatment for adult Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL). 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