Abstract: ObjectiveTo investigate the clinical efficacy and safety of modified VDLP （vincristine+daunorubicin+Lasparaginase+prednisone） regimen in the initial treatment of elderly patients with acute lymphoblastic leukemia （ALL）. 
MethodsFrom January 2013 to March 2015， 82 cases of elderly patients with newly diagnosed ALL in our hospital were randomly divided into observation group and control group， with 41 cases in each group. The observation group was treated with modified VDLP regimen and the control group was treated with traditional VDLP regimen with 28 days a cycle. After 2 cycles， the efficacy was evaluated and the side effects were evaluated with the NCICTCAE 4 version. The median overall survival （OS） and diseasefree survival （DFS） were compared in both groups according to the followup data. 
ResultsAll the 82 patients were evaluable for response. The complete remission rate， response rate and disease control rate of the observation group were 610％， 805％ and 976％， similar with 634％， 854％ and 100％ of the control group （P＞005）. The time to reach complete remission in the observation group was （2334±664）d， similar with （2145±602）d of the control group （P＜005）. The median OS of observation group and control group were 130 months and 120 months， and the median DFS was 75 months and 83 months （P＞005）. The incidence of bone marrow suppression in the observation group was significantly lighter than that in the control group， and the recovery time of bone marrow suppression in the observation group was （943±181）d， similar with （1239±252）d of the control group， and the difference was statistically significant （P＜005）. No significant difference was observed on alimentary tract reaction， alopecia， oral ulcers， hemogram abnormalities， cardiac toxicity， hepatotoxicity and nephrotoxicity between both groups （P＞005）. 
ConclusionThe modified VDLP regimen for the treatment of ALL in the first treatment of the elderly can obtain the shortterm effect equivalent to the traditional VDLP， but the myelosuppression is lighter and faster， which is more suitable for the induction chemotherapy of the elderly patients with ALL.

Key words: Acute lymphoblastic leukemia, Elderly patients, Newly diagnosed, Modified VDLP program