Long-Term Results in Adult AML: Comparison of Postremission Chemotherapy vs. Autologous BMT vs. Allogeneic BMT

From January 1985 to June 1991, three hundred adults aged 15 to 60 years with de novo acute myeloblastic leukemia (AML) were treated in two clinical studies. Induction chemotherapy consisted of thioguanine, cytosine arabinoside, daunorubicin, vincristine, and prednison (TAD-VP). The protocols AML ′85 (using a dose of 45 mg/m2 daunorubicin) and AML ′89 (intensified by two linked obligatory courses of TAD-VP with an increased dose of 60 mg/m2 daunorubicin) resulted in complete remission rates of 54.2% and 58.3%, respectively. All patients achieving complete remission received three courses of consolidation. Patients below 40 years with a HLA-identical sibling were offered bone marrow transplantation (BMT). Patients without HLA-identical sibling and those who refused transplantation were randomized to maintenance therapy given monthly for two years vs. three courses of intensification without any further antileukemic therapy vs. autologous BMT (ABMT) (age below 40 years).