Treatment of acute myeloid leukaemia with early intensive induction therapy

Patients with primary acute myeloid leukaemia were treated with induction therapy consisting of daunorubicin 50 mg/m2 (days 1 and 2) and continuous cytosine arabinoside 400 mg/m2 (days 1-5) with a 7-10-day gap between courses. Consolidation therapy consisted of one further similar course and a final course of cytosine 1 g/m2 infusion (days 1-5). Patients were randomised to receive no further treatment or monthly maintenance therapy consisting of thioguanine 100 mg/m2 twice daily and etoposide 100 mg/m2 twice daily (days 1-5) alternating with CCNU 50 mg/m2 once to a total of 6 courses. 64 patients entered the study; median age was 54 years (range 18-74 years) and 51 patients entered complete remission (79.7%). Thirty-two patients completed consolidation and were randomised between maintenance therapy (n = 16) and no treatment (n = 16). 21 patients have relapsed with neither remission duration nor relapse rate being affected by maintenance therapy.