title: Long-term results in non randomized patients with acute myelogenous leukemia: a single institution experience.
abstract: Sixty-three non randomized adults with acute myelogenous leukemia were treated with an idarubicin-based protocol. The patients achieving complete remission received autologous bone marrow transplantation or (if > 50 years or refusing autologous bone marrow transplantation) high-dose Ara-C, as late intensification. Fifty-two patients (82.5%) achieved complete remission, 45 after one induction course and 16 of them underwent autologous bone marrow transplantation a median of 11 months later. As of December 1997 (median follow-up 112 months, range 50-135 months), 16 patients were still in complete remission (10 after autologous bone marrow transplantation, 6 after high-dose Ara-C) and 29 had relapsed (median time to relapse 14 months, range 2-75 months). Four patients died in complete remission. The median disease-free survival was 25 months; the 50-months and 10-year disease-free survival were 41% and 35% respectively. No significant differences were observed between the autologous bone marrow transplantation and high-dose Ara-C treated patients whose complete remission had lasted more than 11 months. The median disease-free survival in the autografted patients had not been reached after 120 months (the 50-month and 10-year disease-free survival chances were both 67%). Age was the only predictive variable for leukemic relapse. These long-term results confirm the antileukemic efficacy of an idarubicin-containing protocol, which led to high complete remission rates and favorably influenced disease-free survival. Furthermore, the efficacy of late intensification treatment with either autologous bone marrow transplantation or high-dose Ara-C is underscored. The disease-free survival chances after autologous bone marrow transplantation are comparable with those published for allogeneic bone marrow transplantation; however, disease-free survival of the patients receiving a high-dose Ara-C intensification regimen is not significantly worse than that seen after autologous bone marrow transplantation.
authors.affiliation: Cattedra di Medicina Interna, Ospedale Maggiore IRCCS e Università degli Studi di Milano.
authors.forename: G L
authors.initials: GL
authors.lastname: Deliliers
authors.forename: C
authors.initials: C
authors.lastname: Annaloro
authors.forename: A
authors.initials: A
authors.lastname: Oriani
authors.forename: A
authors.initials: A
authors.lastname: Della Volpe
authors.forename: C
authors.initials: C
authors.lastname: Boschetti
authors.forename: A
authors.initials: A
authors.lastname: Cortelezzi
authors.forename: A T
authors.initials: AT
authors.lastname: Maiolo
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007951:Leukemia, Myeloid / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction
chemical_list: D003561:Cytarabine; D015255:Idarubicin