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

Gary Schiller, James Gajewski, Mary Territo, Stephen D Nimer, Myung Lee, Tom Belin, Richard 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
Pages (from-to)2977-2982
Number of pages6
JournalBlood
Volume80
Issue number12
StatePublished - Dec 15 1992
Externally publishedYes

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ASJC Scopus subject areas

  • Hematology

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Schiller, G., Gajewski, J., Territo, M., Nimer, S. D., Lee, M., Belin, T., & Champlin, R. (1992). Long-term outcome of high-dose cytarabine-based consolidation chemotherapy for adults with acute myelogenous leukemia. Blood, 80(12), 2977-2982.