Intensive Chemotherapy for Acute Myelogenous Leukemia

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Abstract
A complete remission rate of 82% was obtained in 68 patients with acute myelogenous leukemia treated with a high-dose induction chemotherapy (TAD) consisting of 7 day courses of 6-thioguanine, cytarabine and daunorubicin. The patients who achieved remission received intensive consolidation chemotherapy and were randomized to receive maintenance chemotherapy with or without immunotherapy. Median remission duration was 13 mo. and median survival, 21 mo. Neither CNS prophylaxis [whole brain irradiation and intrathecal cytarabine] nor the addition of immunotherapy [Propionibacterium acnes and allogeneic leukemia cells] to the maintenance regimen prolonged remissions or improved survival. Age, sex and subclassification of acute myelogenous leukemia had no effect on the remission rate or survival. A large proportion of patients with acute myelogenous leukemia apparently can achieve remission with intensive induction chemotherapy. Attempts to prolong remission were less successful.