Intensive postremission chemotherapy in Taiwanese adults with acute myelogenous leukemia

Intensive postremission chemotherapy has produced disease-free survival comparable to that of bone marrow transplantation in patients with acute myelogenous leukemia (AML), but its efficacy was unknown in Taiwan. We assessed the efficacy of intensive postremission chemotherapy, consisting of high-dose arabinoside-C (HiDAC) with or without transplantation of peripheral blood stem cells, in 33 AML patients from a single institute in Taiwan. Toxic reactions, treatment outcome, prognostic factors, and the size of the peripheral blood stem-cell harvest after HiDAC were analyzed. After a median follow-up of 21 months, 18 patients remained in continuous complete remission. The actuarial leukemia-free survival at 4 years was 51%. Relapse occurred in 12 patients, at a median of 12 months after initial diagnosis. All 6 patients with acute promyelocytic leukemia remained disease free after HiDAC therapy. Age, sex, and number of remission-induction or intensive consolidation chemotherapy courses had no effect on the risk of relapse. Intensive postremission chemotherapy can effectively prolong the duration of remission in young (<60 years of age) adults with AML.