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

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

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

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Acute Myeloid Leukemia
Drug Therapy
Preleukemia
Disease-Free Survival
Thioguanine
Induction Chemotherapy
Daunorubicin
Cytarabine
Granulocytes
Multivariate Analysis
Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Gajewski, J. L., Ho, W. G., Nimer, S. D., Hirji, K. F., Gekelman, L., Jacobs, A. D., & Champlin, R. E. (1989). Efficacy of intensive chemotherapy for acute myelogenous leukemia associated with a preleukemic syndrome. Journal of Clinical Oncology, 7(11), 1637-1645.

Efficacy of intensive chemotherapy for acute myelogenous leukemia associated with a preleukemic syndrome. / Gajewski, J. L.; Ho, W. G.; Nimer, Stephen D; Hirji, K. F.; Gekelman, L.; Jacobs, A. D.; Champlin, R. E.

In: Journal of Clinical Oncology, Vol. 7, No. 11, 01.01.1989, p. 1637-1645.

Research output: Contribution to journalArticle

Gajewski, JL, Ho, WG, Nimer, SD, Hirji, KF, Gekelman, L, Jacobs, AD & Champlin, RE 1989, 'Efficacy of intensive chemotherapy for acute myelogenous leukemia associated with a preleukemic syndrome', Journal of Clinical Oncology, vol. 7, no. 11, pp. 1637-1645.
Gajewski, J. L. ; Ho, W. G. ; Nimer, Stephen D ; Hirji, K. F. ; Gekelman, L. ; Jacobs, A. D. ; Champlin, R. E. / Efficacy of intensive chemotherapy for acute myelogenous leukemia associated with a preleukemic syndrome. In: Journal of Clinical Oncology. 1989 ; Vol. 7, No. 11. pp. 1637-1645.
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