[The Münster study of intensive induction and consolidation therapy without maintenance therapy of acute myeloid leukemia. Results of 93 patients--cellular determinants for response and length of remission].
A 9-day high-dose 3-drug induction regimen including ARA-C, DNR, and TG at special time sequencing was given to 93 patients with AML, 15-74 (median 52) years old. After 1-2 courses for remission induction and, if possible, 2 identical courses of consolidation, no further therapy was applied during remission. Complete remission (CR) was achieved in 71% of all patients and in 74% of responders by 1 course only. Median remission duration is at 1 year with 13 patients in continuous CR for 13-38 (median 24) months. Patients completing consolidation reached a median remission duration of 22 months and those with rapid response to 1 induction course and with complete consolidation 38+ months. Patients monitoring included bone marrow DNA-histograms by flow cytometry, blood counts, percentage, and absolute number of blasts in bone marrow and LDH in serum. Among pretherapeutic parameters only LDH (inversely) correlated with CR duration. In contrast during early therapy rapid blast reduction, decrease of S-phase-index and of LDH as well as short recovery time of platelets and neutrophils predicted for low risk (when high risk included non-response and early relapse). Thus, monitoring of early cellular response parameters reflecting cellularity and proliferation seems to provide important individual determinants of therapeutic outcome.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001792:Blood Platelets / Q000187:drug effects; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005860:Germany, West; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000201:enzymology; D008875:Middle Aged; D013866:Thioguanine / Q000008:administration & dosage; D013997:Time Factors
D000970:Antineoplastic Agents; D003561:Cytarabine; D007770:L-Lactate Dehydrogenase; D013866:Thioguanine; D003630:Daunorubicin
Die Studie Münster über intensivierte Induktions- und Konsolidierungstherapie ohne Erhaltungstherapie der AML. Resultate bei 93 Patienten--Zelluläre Determinanten für Response und Remissionsdauer.