Early intensification and short-term maintenance chemotherapy does not prolong survival in acute myelogenous leukemia

Forty-one previously untreated patients with a diagnosis of acute myelogenous leukemia (AML) were entered on a study using early intensification followed by a short-term maintenance chemotherapy. Induction and early intensification consisted of three to four cycles of doxorubicin, vincristine, cytosine arabinoside (Ara-C) and prednisone (ADOAP) in escalating dosages. Maintenance therapy used three cycles of Ara-C thioguanine (AT), followed by three cycles of cyclophosphamide and rubidazone with vincristine and prednisone (CROP). Median total duration of therapy was 9 months. The overall complete remission (CR) rate was 73%. Tolerance to chemotherapy and dose escalation were better for patients who received their induction and early intensification in the protected environment. The overall median survival was 75 weeks. Compared to a historical control group treated with long-term maintenance chemotherapy, patients achieving CR on the current study had similar median remission (52 versus 65 weeks; P = 0.3) and survival durations (94 versus 98 weeks). This regimen using early intensification and short-term maintenance chemotherapy did not improve the overall prognosis of this AML population.