Rationale for high-dose chemotherapy and application of haematopoietic growth factors in acute myeloid leukaemia.
High-dose chemotherapy in acute myeloid leukaemia (AML) is more effective and not associated with a higher risk of lethal complications during the induction phase as compared with less intensive regimens. This seemingly paradoxical finding is explained by the more rapid reduction of the leukaemic cell mass and the faster restoration of normal haematopoesis. In the most recent study on double induction therapy by the German AML Cooperative Group involving 665 adult patients with AML the rate of complete remission was 66%-73%. Haematopoietic growth factors used as part of the anti-tumour regimen offer a number of advantages. These include acceleration of haematopoietic recovery and the potential to enhance the sensitivity of leukaemic blasts when given prior to and during cytostatic therapy. New perspectives to further enhance the intensity of antileukaemic therapy may emerge from the introduction of peripheral stem cell transplantation into the treatment strategy.
Hiddemann
W
W
Department of Haematology and Oncology, University of Gottingen, Germany.
Buchner
T
T
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*
D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor