Our results show that age, hemorrhagic diathesis, and initial leukocyte count are prognostic factors for APL treated with ATRA followed by intensive chemotherapy.

BACKGROUND A major concern in the treatment of patients with acute myeloid leukemia (AML) is how to prevent disease recurrences. Although intensive consolidation therapy has proven useful, the effectiveness of maintenance therapy remains controversial. METHODS Seven hundred eighty‐nine patients ages 15–64 (median: 45 yrs) with de novo AML received induction therapy, which consisted of cytosine arabinoside (at a dose of 100 mg/m2 on Days 1–7) and idarubicin (at a dose of 12 mg/m2 on Days 1–3). The patients who achieved complete remission (CR) were then randomized into groups that received either four courses of standard‐dose consolidation therapy without maintenance (Arm A) or three courses of standard‐dose consolidation and six courses of maintenance therapy (Arm B). RESULTS In total, 78.7% of patients achieved CR. The 5‐year overall survival (OS) rate for the 789 eligible patients was 46.9%, and the disease‐free survival (DFS) rate for the 621 patients who achieved CR was 32.9%. The 5‐year OS rate for Arm A was 52.4%, and 58.4% for Arm B (P = 0.599). The 5‐year DFS rate for the patients who achieved CR was 35.8% in Arm A and 30.4% in Arm B (P = 0.543). In analyzing the data according to the risk groups, no statistical difference was observed either in the 5‐year OS rate or in the 5‐year DFS rate between the 2 arms. CONCLUSIONS In the current study, the Japan Adult Leukemia Study Group's conventional postremission therapy (three courses of standard‐dose consolidation and six courses of maintenance therapy) was replaced successfully by a shorter duration of four courses of standard‐dose consolidation therapy without the need for additional maintenance therapy. Cancer 2005. © 2005 American Cancer Society.

M-CSF significantly reduced the incidence and duration of febrile neutropenia during the intensive consolidation therapy, and shortened the time to complete consolidation chemotherapy in AML.

We prospectively compared allogeneic hematopoietic stem cell transplantation (allo-HSCT) with chemotherapy as a post-remission therapy in a multicenter trial (JALSG AML97) of adult patients with intermediate or poor risk acute myeloid leukemia (AML). Of 503 patients aged 15-50 years old registered between December 1997 and July 2001, 392 achieved complete remission (CR). CR patients classified in the intermediate or poor risk group using a new scoring system were tissue typed. Seventy-three with and 92 without an HLA-identical sibling were assigned to the donor and no-donor groups. Of 73 patients in the donor group, 38 (52%) received allo-HSCT during CR1 and 17 (23%) after relapse. Intention-to-treat analysis revealed that the relapse incidence was reduced in the donor group (52 vs. 77%; p = 0.008), and the disease-free survival (DFS) improved (39 vs. 19%; p = 0.016), but overall survival (OS) was not significantly different (46 vs. 29%; p = 0.088). The OS benefit was seen in the patients aged 36-50 years old (49 vs. 24%; p = 0.031), suggesting an advantage of allo-HSCT among older patients with leukemia that is more resistant to chemotherapy than that among younger patients.

No abstract