Efficacy of intensive chemotherapy for acute myelogenous leukemia associated with a preleukemic syndrome

J. L. Gajewski, W. G. Ho, S. D. Nimer, K. F. Hirji, L. Gekelman, A. D. Jacobs, R. E. Champlin

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101 Scopus citations

Abstract

One hundred ninety-six patients with acute myelogenous leukemia (AML) were treated with intensive induction chemotherapy using similar daunorubicin/cytarabine/thioguanine regimens. Treatment results of 44 patients who had a documented preleukemic syndrome or cytopenia present for more than 2 months before developing overt AML were compared with 152 patients with de novo AML. Eighteen (41%) patients with preleukemia evolving into AML achieved complete remission compared with 111 (73%) patients with de novo AML (P < .01). Patients with preleukemia-AML had a significantly longer period to recovery of granulocytes. Multivariate analysis indicated that presence of a previous preleukemic syndrome and advancing age were independent poor prognostic indicators for achieving remission. For patients who achieved remission, disease-free survival and overall survival were also inferior for patients with previous preleukemia; disease-free survival was 17 ± 17% at 3 years compared with 29 ± 10% in patients with de novo AML (P = .02). These data indicate that intensive chemotherapy has limited efficacy in patients with AML following a preleukemic syndrome. Durable remissions may be achieved in some patients.

Original languageEnglish (US)
Pages (from-to)1637-1645
Number of pages9
JournalJournal of Clinical Oncology
Volume7
Issue number11
DOIs
StatePublished - Jan 1 1989
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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