Journal of Clinical Oncology, Vol 6, 218-226, Copyright © 1988 by American Society of Clinical Oncology
Short-term therapy for acute myelogenous leukemia
AZ Rohatiner, WM Gregory, R Bassan, MJ Barnett, J Waxman, MA Richards, TS Ganesan, J Tucker, ST Malik and R Biruls
Department of Medical Oncology, St. Bartholomew's Hospital, London, England.
Since 1978, 187 patients (age range, 15 to 59, median 44 years) have
received short-term chemotherapy as part of three sequential open studies
(B-IX, X, Xb) or a randomized clinical trial (B-XI). An intended six cycles
of Adriamycin (ADR) (doxorubicin; Adria Laboratories, Columbus, OH),
cytarabine (ara-C), and thioguanine (TG) were administered with as short an
intercycle time as possible. No further therapy was administered. Complete
remission (CR) was achieved in 118 of 187 patients (63%). On univariate and
multivariate analyses achievement of CR correlated adversely with a low
serum albumin at presentation and an antecedent marrow disorder. Forty-five
patients continue in first remission between 15 months and 8 1/2 years, no
relapses being seen after 3 1/2 years (median follow-up, 3 1/2 years). The
median duration of remission was 1 year. M3 morphology, a blast count less
than 100 x 10(9)/L, and absence of hepatosplenomegaly correlated favorably
with remission duration. There was no difference in duration of remission
between patients receiving 3, 4, 5, or 6 cycles. The best results overall
were achieved in patients under the age of 40, with 43% projected to remain
free of disease at 5 years. Fifty patients remain alive between 17 months
and 9 years, the predicted actuarial survival being 25% at 5 years.
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