title: Fate of patients with newly diagnosed acute myeloid leukemia who fail primary induction therapy.
abstract: The aim of this study was to describe the fate of patients with newly diagnosed acute myeloid leukemia (AML) who did not achieve an initial remission while being treated on a contemporary cooperative group trial. We analyzed the outcome of patients entered into S0106, a recently reported cooperative group trial for patients with newly diagnosed AML. A total of 589 eligible patients was treated, of whom 150 (25%) did not achieve a remission while on study and were available for further analysis. The 4-year survival rate for the entire cohort of 150 patients was 23%. Among the 64 patients who received an allogeneic hematopoietic cell transplant, the 4-year survival rate was 48% compared with 4% for the 86 patients who did not undergo transplantation. Among those transplanted, we could not detect a difference in outcome according to remission status, donor source, type of preparative regimen, or cytogenetic risk category. More than 20% of patients with newly diagnosed AML who fail induction therapy can still be cured, particularly if they are able to receive an allogeneic hematopoietic cell transplant. These results suggest that early HLA typing and donor identification are important components of the initial therapy of AML.
authors.affiliation: Public Health Sciences, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Megan
authors.initials: M
authors.lastname: Othus
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Electronic address: fappelba@fhcrc.org.
authors.forename: Frederick R
authors.initials: FR
authors.lastname: Appelbaum
authors.affiliation: Seattle Genetics, Seattle, Washington.
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Petersdorf
authors.affiliation: Public Health Sciences, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Public Health Sciences, SWOG Statistical Center, Seattle, Washington.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Kopecky
authors.affiliation: Cytogenetics, Sonora Quest, Tempe, Arizona.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Slovak
authors.affiliation: Haematology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Nevill
authors.affiliation: Haematology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Joseph
authors.initials: J
authors.lastname: Brandwein
authors.affiliation: Hematologic Malignancies, University of Chicago, Chicago, Illinois.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Larson
authors.affiliation: Hematology/Oncology, Loyola University Medical Center, Maywood, Illinois.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Stiff
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Roland B
authors.initials: RB
authors.lastname: Walter
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Martin S
authors.initials: MS
authors.lastname: Tallman
authors.affiliation: Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Leif
authors.initials: L
authors.lastname: Stenke
authors.affiliation: University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Harry P
authors.initials: HP
authors.lastname: Erba
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
keywords: Acute myeloid leukemia; Hematopoietic cell transplantation; Induction failure