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

Research output: Contribution to journalArticle

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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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Consolidation Chemotherapy
Chemotherapy
Cytarabine
Acute Myeloid Leukemia
Consolidation
Leukemia
Anthracyclines
Survival
Toxicity
Preleukemia
Induction Chemotherapy
Cytogenetics

ASJC Scopus subject areas

  • Hematology

Cite this

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.

Long-term outcome of high-dose cytarabine-based consolidation chemotherapy for adults with acute myelogenous leukemia. / Schiller, Gary; Gajewski, James; Territo, Mary; Nimer, Stephen D; Lee, Myung; Belin, Tom; Champlin, Richard.

In: Blood, Vol. 80, No. 12, 15.12.1992, p. 2977-2982.

Research output: Contribution to journalArticle

Schiller, G, Gajewski, J, Territo, M, Nimer, SD, Lee, M, Belin, T & Champlin, R 1992, 'Long-term outcome of high-dose cytarabine-based consolidation chemotherapy for adults with acute myelogenous leukemia', Blood, vol. 80, no. 12, pp. 2977-2982.
Schiller G, Gajewski J, Territo M, Nimer SD, Lee M, Belin T et al. Long-term outcome of high-dose cytarabine-based consolidation chemotherapy for adults with acute myelogenous leukemia. Blood. 1992 Dec 15;80(12):2977-2982.
Schiller, Gary ; Gajewski, James ; Territo, Mary ; Nimer, Stephen D ; Lee, Myung ; Belin, Tom ; Champlin, Richard. / Long-term outcome of high-dose cytarabine-based consolidation chemotherapy for adults with acute myelogenous leukemia. In: Blood. 1992 ; Vol. 80, No. 12. pp. 2977-2982.
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