Long-term follow-up of patients with newly diagnosed acute myeloid leukemia treated at the University of Texas M.D. Anderson Cancer Center.
BACKGROUND
Chemotherapy is known to cure a small minority of patients with acute myeloid leukemia (AML). Less is known about the risk of such patients developing subsequent cancers or about their ability to return to work.


METHODS
The authors analyzed outcomes among 1892 patients who received treatment for newly diagnosed AML at the University of Texas M. D. Anderson Cancer Center from 1965 to May 1995.


RESULTS
Because failure rates declined to relatively low levels after a first or later complete remission of > or = 3 years' duration, such patients comprised a "potentially cured" cohort. The criterion for entry into this cohort was fulfilled by 215 patients (10.7%; 203 in first complete remission and 12 in second remission). At a median of 6.2 years after entry into the cohort (i.e., 9.2 years from complete remission), 163 patients (76%) remain alive and in complete remission. Approximately 9% and 5% of the 1892 patients have been in complete remission for > 5 years and > 10 years, respectively. The pretreatment prognostic importance of cytogenetics is still apparent even after 5 years in complete remission. On average, members of the potentially cured cohort were not observed to be at increased risk of subsequent invasive malignancies compared with a normal population. Furthermore, two-thirds of those in the potentially cured cohort who were working full time before diagnosis of AML claimed to have returned to full-time work. Of those not working, only 10% cited physical limitation as the reason.


CONCLUSIONS
The major threat to the life and well-being of the patient with AML is clearly the disease and not its treatment.
Estey
E
E
Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
deLima
M
M
Strom
S
S
Pierce
S
S
Freireich
E J
EJ
Keating
M J
MJ
D000208:Acute Disease; D000328:Adult; D004651:Employment; D005500:Follow-Up Studies; D006801:Humans; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D016609:Neoplasms, Second Primary; D017211:Treatment Failure; D016896:Treatment Outcome