POOR-PROGNOSIS ACUTE MYELOGENOUS LEUKEMIA

Poor prognosis AML consists of 3 clinically definable groups of patien ts whose response to therapy is substantially worse than that of stand ard prognosis patients. The response rate is lowest for those patients who have more than a single risk factor and for the patients who have low platelet and serum albumin levels at diagnosis. The treatment ass ociated mortality of the latter patients is quite high. Even if one av oids the high mortality rate by carefully selecting patients the likel ihood that drug resistant disease is present is very high. Since the b asis for resistance is multifactorial, a variety of strategies will ha ve to be explored as means to improve treatment outcome. At the presen t time, the greatest chance for long term survival is found in relativ ely young patients whose AML is induced into complete remission and wh o then receive a matched allogeneic bone marrow transplant.