POST-REMISSION THERAPY OF ADULT ACUTE MYELOID LEUKEMIA: HIGH DOSE CYTOSINE-ARABINOSIDE VERSUS OTHER CONSOLIDATION REGIMENS KONSOLIDACIONA TERAPIJA AKUTNE MIJELOIDNE LEUKEMIJE: VISOKE DOZE CITOZIN- ARABINOZIDA NASPRAM DRUGIH KONSOLIDACIONIH REŽIMA SA CITOZIN-ARABINOZIDOM

Summary Introduction. Modern therapy makes it possible for 60-80% patients with acute myeloid leukemia to achieve complete re- mission after induction therapy. However, most of them will relapse within six months to a year without additional cytostat- ic therapy. The questions regarding post-remission therapy re- main unanswered. The objective of this study was to compare the survival and relapse rate among the patients who had re- ceived high dose cytosine-arabinoside during consolidation therapy and the patients who had not received high dose cyto- sine-arabinoside during consolidation therapy. Material and Methods. The study included 59 patients aged 18-60 years with de novo acute myeloid leukemia (except for Acute promyelo- cytic leukemia, which was excluded according to the French- American-British classification) who achieved complete remis- sion. Thirty-nine patients who received high dose cytosine-ara- binoside during consolidation were included in the study group and twenty patients who did not receive high dose cytosine- arabinoside during consolidation were in the control group. Re- sults. The results show a statistically significantly longer sur- vival rate (p= 0.003) and a lower relapse rate (p= 0.02) among the study group patients, who received high dose cytosine-ara- binoside during consolidation, compared to the controls, who did not receive high dose cytosine-arabinoside. The univariate analysis in the study group suggests that the affiliation to Acute myeloblastic leukemia with maturation and Acute myelomono- cytic leukemia subgroups, as well as achieving complete remis- sion after a single induction therapy has the prognostic signifi- cance. In the multivariate analysis, only the affiliation to Acute myeloblastic leukemia with maturation and Acute myelomono- cytic leukemia subgroups retained the independent prognostic significance. Conclusion. This study has demonstrated that high dose cytosine-arabinoside used for consolidation therapy results in the higher survival rate and lower relapse rate com- pared to consolidation therapy without high dose cytosine-arab- inoside. Only the patients within Acute myeloblastic leukemia with maturation and Acute myelomonocytic leukemia subgroups benefited significantly from high dose cytosine-arabinoside.