Cures of leukemia with aggressive postremission treatment: an update of timed sequential therapy (Ac-D-Ac)

A cure rate can be obtained with intensive cytoreductive treatment given to a subset of patients with acute myelocytic leukemia in bone marrow remission. This report updates our experience with postremission timed sequential therapy using cytarabine and daunorubicin (Ac-D-Ac) and compares it with other brief, aggressive strategies including bone marrow transplantation. The median disease-free survival (DFS) of all patients treated in remission is 2.5 years with a greater than 40% probability of DFS at 8 years. These results are similar to those achieved with bone marrow-ablative and other intensive but nonablative treatment plans.