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Summary:vary from one study to another, they show generally a lower risk of relapse, and a longer disease-free survival (DFS) after AlloBMT and ABMT than after ICC. A cross-sectional study of quality of life (QOL) was performed in 98 patients in continued first complete From 1986 to 1992, the EORTC and GIMEMA Leukemia Cooperative Groups prospectively compared these remission (CR) for 1-7.4 years, after inclusion in the AML 8A trial which prospectively compared allogeneic three therapeutic options: patients with newly diagnosed AML were entered in the AML 8A trial, and, after the same bone marrow transplantation (AlloBMT), autologous BMT (ABMT) and intensive consolidation chemoinduction and intensive consolidation course, were assigned, according to availability of a family HLAtherapy. Several significant differences between the three treatment groups were observed, on the basis of matched donor or randomization, to AlloBMT, ABMT or a second ICC course. At a median follow-up time of 3.3 patient self-reports, with regard to somatic symptoms (mouth sores, cough, hair loss, headache), repeated years, there was a significantly longer DFS in the AlloBMT (55%) and ABMT (48%) arms than in the ICC arm (30%). 5 acute medical problems, physical functioning, role functioning, leisure activities and, above all, sexual funcHowever, the overall survival after CR was similar in the three arms, patients relapsing after ICC being more easily tioning. There were also significant differences for overall physical condition, and overall quality of life. For all salvaged and frequently receiving an ABMT during second CR. these parameters, the ranking was uniformly AlloBMT lower than ABMT lower than chemotherapy. These dif-The conclusions of this study were based on analyses made according to the intention-to-treat principle. In ferences remain significant after adjustment for time interval between CR and QOL evaluation, sex or age.addition, we have observed a significant difference with regard to the short-term toxicity of the treatment actually These results, confirming a higher risk of permanent impairment of QOL after BMT, may have an impact administered, the treatment-related mortality being 20, 10 and 6% after AlloBMT, ABMT and second ICC, respecton medical decisions and warrant further studies. Keywords: quality of life; acute myeloid leukemia; bone ively. Furthermore, the final results may also be hampered by long-term toxicity, especially due to the conditioning marrow transplantation regimens, with or without total body irradiation (TBI), for both BMT procedures, and to chronic graft-versus-host disease (GVHD) after AlloBMT. Such long-term somatic toxiAllogeneic bone marrow transplantation (AlloBMT), autocity is also likely to induce psychosocial sequelae. Indeed, logous bone marrow transplantation (ABMT), or intensive some previous studies have shown that quality of life consolidation chemotherapy (ICC) are currently proposed (QOL) might be more or less markedly impaired after for patients with acute myelogenous leukemia (AM...

Summary.To determine whether patients with a HLAidentical sibling donor have a better outcome than patients without a donor, an analysis on the basis of intention-totreat principles was performed within the framework of the EORTC-GIMEMA randomized phase III AML 8A trial. Patients in complete remission (CR) received one intensive consolidation course. Patients with a histocompatible sibling donor were then allocated allogeneic bone marrow transplantation (alloBMT), the patients without a donor were randomized between autologous BMT (ABMT) and a second intensive consolidation (IC2). 831 patients <46 years old and alive >8 weeks from diagnosis were included. HLA typing was performed in 672 patients. AlloBMT was performed during CR1 in 180 (61%) out of 295 patients with a donor. Another 38 patients were allografted: five in resistant disease, 14 during relapse and 19 in CR2. ABMT was performed in 130 (34%) out of 377 patients without a donor in CR1, in six (2%) patients during relapse and in 38 (10%) patients during CR2. The disease-free survival (DFS) from CR for patients with a donor was significantly longer than for patients without a donor (46% v 33% at 6 years; P ¼ 0·01, RR 0·78, 95% confidence interval 0·63-0·96). The overall survival from diagnosis for patients with a donor was longer, but not statistically significant, than for patients without a donor (48% v 40% at 6 years; logrank P ¼ 0·24). When patients were stratified according to prognostic risk groups, the same trend in favour of patients with a donor was seen for survival duration and the DFS remained significantly longer for this group of patients.

The analysis of molecular lesions in B-DLCL may be useful for a better diagnostic definition; however, in this study we were unable to show that the evaluated genetic lesions had a significant impact on clinical outcome.