Options for postremission therapy in acute leukemia

Remission induction therapy for patients with AML results in 65% to 75% CR with 20% prolonged DFS. Postremission therapy increases the incidence of prolonged DFS to more than 60%. Postremission therapy in AML consists of high-dose or intensive chemotherapy with or without BMT. Each therapy has significant toxicity and risk for the patient. Induction therapy for patients with ALL includes systemic and intrathecal chemotherapy with a 70% to 75% CR rate. Maintenance therapy continues for 2 to 3 years, and BMT is indicated for patients with early relapse or certain high-risk factors. Knowledgeable nurses provide much-needed emotional support for patients as they struggle to make the best decision for postremission therapy.