Long-term outcome of high-dose cytarabine-based consolidation chemotherapy for adults with acute myelogenous leukemia

G. Schiller, J. Gajewski, M. Territo, S. Nimer, M. Lee, T. Belin, R. Champlin

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    84 Scopus citations

    Abstract

    Modern induction chemotherapy produces 60% to 80% complete remissions in adults with newly diagnosed acute myelogenous leukemia. A major challenge is to eradicate subclinical disease in remission and prevent leukemic relapse. We analyzed the long-term results of high-dose cytarabine-anthracycline consolidation chemotherapy without maintenance treatment and examined the effect of major prognostic factors, including age, sex, history of preleukemia, and cytogenetics. Two hundred twenty-seven patients with newly diagnosed acute leukemia were enrolled on two sequential studies conducted from 1982 to 1991. One hundred fifty-one patients (67%) achieved a complete remission. One hundred twenty-three patients were eligible for high-dose cytarabine-based consolidation administered in two to three courses. After a median follow-up of 4.8 years, 40 patients remain alive, with 28 in continued remission. Median remission duration for all eligible patients is 12.8 months, and actuarial leukemia-free survival (LFS) at 5 years is 26% ± 8%. Advanced age and male sex were negative prognostic indicators for LFS. For patients ≤45 years of age, 5-year LFS was 35% ± 13%, as compared with 18% ± 11% for patients greater than age 45 (P = .03). Toxicity of consolidation chemotherapy included treatment-related death in nine patients and serious neurotoxicity in five. Our results show an improved LFS for younger patients treated with high-dose cytarabine-based consolidation. There was no apparent benefit for older patients compared with reported data with less intensive regimens.

    Original languageEnglish (US)
    Pages (from-to)2977-2982
    Number of pages6
    JournalBlood
    Volume80
    Issue number12
    DOIs
    StatePublished - 1992

    ASJC Scopus subject areas

    • Biochemistry
    • Immunology
    • Hematology
    • Cell Biology

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