[Short-term intensive consolidation chemotherapy in the treatment of acute nonlymphocytic leukemia]

Thirty-four adults with AML were treated with conventional remission induction chemotherapy consisting of Ara-C and daunorubicin. The median age was 55 years. Thirty (88%) patients showing complete remission (CR) were treated with four courses of intensive consolidation chemotherapy: course 1 with 7 days Ara-C and 4 days of mitoxantrone; course 2 and 7 days Ara-C, 5 days of etoposide, vincristine day 10 and vinblastine day 12 (A-Triple-V); course 3 with 7 days Ara-C and 3 days of aclacinomycin; course 4 with 7 days Ara-C and 3 days of daunorubicin. Then patients were observed without further therapy until relapse. The median duration of relapse-free survival for patients < 60 years of age was 13 months, with 49% patients projected to continue first CR at 52 months. In contrast, only 19% of patients 60 years or older were projected to be in CR at 22 months. Most patients experienced significant side effects including fever, liver dysfunction, pneumonia and septicemia during consolidation therapies. Short-term intensive consolidation therapy appeared to be efficacious for patients < 60 years of age. The results in older individuals were worse than expected, and the use of G-CSF was suggested to improve this problem.