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- Title
Treatment of acute myeloid leukemia with a combination of intensive induction chemotherapy, early consolidation, splenectomy and long-term maintenance chemotherapy.
- Authors
Machover, David; Rappaport, Henry; Schwarzenberg, Léon; Misset, Jean-Louis; Goldschmidt, Emma; Lemaigre, Guy; Dorval, Thierry; de Vassal, Francoise; Ribaud, Patricia; Gaget, Héléne; Mathe, Georges; Machover, D; Rappaport, H; Schwarzenberg, L; Misset, J L; Goldschmidt, E; Lemaigre, G; Dorval, T; De Vassal, F; Ribaud, P
- Abstract
The authors developed a therapeutic regimen in which 33 patients aged 11 to 61 years (mean +/- SE, 35.9 +/- 2.3 years) with acute myeloid leukemia (AML) were given intensive induction chemotherapy with Adriamycin (doxorubicin) (ADM), vincristine (VCR) and cytosine arabinoside (ARA-C). Twenty-nine of these patients (88%) attained a complete remission (CR) after 1, 2, or 3 courses and were then subjected to an early consolidation course of chemotherapy, identical to that for induction. After consolidation, all patients in CR received a long-term continuous maintenance therapy in which 6-mercaptopurine (6-MP) and methotrexate (MTX) were alternated, associated with periodic reinforcements with daunorubicin (DNR) and VCR. Twenty-five of the 29 patients who achieved a CR were splenectomized soon after the consolidation course. Histologic sections of the spleens, liver biopsy specimens, and lymph nodes, stained routinely and with the naphthol AS-D chloroacetate esterase (NCA) method, showed mature granulocytes and a few NCA positive mononuclear cells, but no proved leukemic infiltrates. For the 25 splenectomized patients, the probability of remaining in CR at 36 and 54 months was 75% and 66%, respectively; the probability of survival at 36 and 54 months was 85% and 75%, respectively. Age older than 40 years and evidence of extramedullary involvement at presentation appeared to carry a bad prognosis for disease-free survival.
- Publication
Cancer (0008543X), 1984, Vol 53, Issue 8, p1644
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/1097-0142(19840415)53:8<1644::AID-CNCR2820530804>3.0.CO;2-#