To examine the efficacy of intensified maintenance chemotherapy, we conducted a prospective multicenter trial in adult patients with newly diagnosed acute promyelocytic leukemia treated with alltrans retinoic acid and chemotherapy. Of the 302 registered, 283 patients were assessable and 267 (94%) achieved complete remission. Predicted 6-year overall survival in all assessable patients and disease-free survival in patients who achieved complete remission were 83.9% and 68.5%, respectively. A total of 175 patients negative for PML-RAR␣ at the end of consolidation were randomly assigned to receive either intensified maintenance chemotherapy (n ‫؍‬ 89) or observation (n ‫؍‬ 86). Predicted 6-year disease-free survival was 79.8% for the observation group and 63.1% for the chemotherapy group, showing no statistically significant difference between the 2 groups (P ‫؍‬ .20). Predicted 6-year survival of patients assigned to the observation was 98.8%, which was significantly higher than 86.2% in those allocated to the intensified maintenance (P ‫؍‬ .014). These results indicate that the intensified maintenance chemotherapy did not improve disease-free survival, but rather conferred a significantly poorer chance of survival in acute promyelocytic leukemia patients who have become negative for the PML-RAR␣ fusion transcript after 3 courses of intensive consolidation therapy. (Blood. 2007;110:59-66)

These results indicate that fatal hemorrhage represents a major obstacle in curing APL, and that patients with such high-risk features may benefit from more aggressive supportive care.

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A series of laboratory experiments in an oscillatory tank was carried out to investigate the sheet flow of sediment. Objectives of the study were to determine the criterion for inception of sheet flow, and to evaluate the sediment transport rate under the sheet flow condition. In order to proceed with the investigation, it was necessary to develop devices appropriate for tracing the sediment particle movement, and for measuring the extremely dense sediment concentration in the moving layer of sheet flow. The chief results are: 1) the criteria for the inception of sheet flow given by Manohar C1955) and by Komar and Miller (1974) are both applicable to materials composed of spheroidal particles, and 2) the average rate of sediment transport for sheet flow is well described by an empirical relationship given by Madsen and Grant (1976) for the bed load transport rate on a plane bed in oscillatory flow.

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