Duration of second complete remission compared with first complete remission in patients with acute myeloid leukemia

The prognosis for patients with acute myeloid leukemia in first relapse is generally poor. The ability to induce a second complete remission (CR) with the same chemotherapy used in initial induction therapy is limited. Remiss ion inversion rate, defined as achieving a longer second CR than the first CR in response to standard chemotherapy for relapse, is important in assess ing studies of novel chemotherapy or immunologic treatment strategies for p atients with relapsed disease. One hundred and twenty-four patients entered on two Eastern Cooperative Oncology Group (ECOG) studies for patients with relapsed AML were analyzed to determine the remission inversion rate. Twen ty-two of the 124 patients (18%; 95% confidence interval 12-26%) experience d a longer second CR duration than the first CR duration by at least 2 mont hs. Inversion of CR duration is thus not a rare event. The inversion freque ncy reported here establishes a baseline upon which future studies in relap sed disease need to be defined.