Intensive postremission chemotherapy in Taiwanese adults with acute myelogenous leukemia

Intensive postremission chemotherapy has produced disease-free survival com parable to that of bone marrow transplantation in patients with acute myelo genous leukemia (AML), but its efficacy was unknown in Taiwan. We assessed the efficacy of intensive postremission chemotherapy, consisting of high-do se arabinoside-C (HIDAC) with or without transplantation of peripheral bloo d stem cells, in 33 AML patients from a single institute in Taiwan. Toxic r eactions, treatment outcome, prognostic factors, and the size of the periph eral blood stem-cell harvest after HiDAC were analyzed. After a median foll ow-up of 21 months, 18 patients remained in continuous complete remission. The actuarial leukemia-free survival at 4 years was 51%. Relapse occurred i n 12 patients, at a median of 12 months after initial diagnosis. All 6 pati ents with acute promyelocytic leukemia remained disease free after HiDAC th erapy. Age, sex, and number of remission-induction or intensive consolidati on chemotherapy courses had no effect on the risk of relapse. Intensive pos tremission chemotherapy can effectively prolong the duration of remission i n young (< 60 years of age) adults with AML.