[Current principles of treatment of acute nonlymphoblastic leukemia]

Present-day chemotherapy warrants complete remissions in 45-70% of patients with acute nonlymphoblastic leukemia. However, therapeutic policy at the stages of remission induction and residual disease remains disputable. The authors studied the role of 3 chemotherapy programs (7 + 3, 7 + 3 + vincristine, C-ROPM) in achievement of remission of acute leukemia and effects of long-term standard regimens of remission maintenance and bone marrow transplantation on long-term relapse-free survival of patients. The addition of vincristine to the program 7 + 3 failed to make remission more frequent and recurrence-free survival longer. C-ROMP program warranted remission in 70% of patients, this proportion being significantly higher than on programs 7 + 3 and 7 + 3 + vincristine. More intensive chemotherapy during remission induction resulted in a rise of 4-year recurrence-free survival from 12 to 44%. Bone marrow transplantation used for treatment intensification in remission increased 4-year recurrence-free survival compared to standard chemotherapy from 44 to 80%.