OUTCOME OF A MULTICENTER TREATMENT PROGRAM INCLUDING AUTOLOGOUS OR ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR DE-NOVO ACUTE MYELOID-LEUKEMIA

The results of an intensive treatment program for patients 16-60 yr of age with de novo acute myeloid leukemia are presented. The patients w ere given conventional induction treatment with daunorubicin and cytar abine. Patients not entering complete remission (CR) after 1 course of daunorubicin/cytarabine were given 1 course of amsacrine/etoposide/cy tarabine. Those entering complete remission received 3 consolidation c ourses using mitoxantrone, etoposide, amsacrine and cytarabine. One hu ndred and eighteen patients were enrolled. Complete remission was atta ined after 1-2 courses in 90 patients (76%). Another 6 patients reache d CR after 3-4 induction courses for a total CR rate of 81%. If feasib le, patients were offered either allogeneic or unpurged autologous bon e marrow transplantation. Twenty-four patients underwent allogeneic bo ne marrow transplantation; 15 in first remission, 8 in second remissio n, 1 in early relapse. Thirty patients below 56 yr of age underwent au tologous bone marrow transplantation in first remission. The overall p robability of survival at 4 yr was 34%, and for patients below 40 yr o f age 50%. Leukemia-free survival was 35% for the whole cohort of pati ents; 52% for patients below 40 yr of age. Patients undergoing allogen eic or autologous bone marrow transplantation in first remission had a n overall survival of 86% and 47%, respectively, while the probability of leukemia-free survival in these groups was 87% vs. 40% at 4 yr. Th e CR rate and long-term results of this intensive treatment program co mpare favorably with other recent studies using intensive consolidatio n with allogeneic or autologous bone marrow transplantation or high do se cytarabine.