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A randomized study of the efficacy of consolidation therapy in adult acute
nonlymphocytic leukemia
PA Cassileth, CB Begg, JM Bennett, M Bozdech, SB Kahn, C Weiler and JH Glick
The Eastern Cooperative Oncology Group conducted a randomized study to
determine the efficacy of consolidation therapy in prolonging the duration
of complete remission (CR) in adults with acute nonlymphocytic leukemia
(ANLL). Induction chemotherapy with daunorubicin, cytosine arabinoside, and
6-thioguanine (DAT) yielded CR in 65% of 283 patients with ANLL, aged
16-69. For patients aged 60-69, the CR rate was 58%. Of 184 patients in CR,
146 patients were then randomized to receive either maintenance therapy
with weekly cytosine arabinoside and 6-thioguanine alone (69 patients) or
two courses of reduced doses of DAT 1 mo apart, before commencing the same
maintenance program (77 patients). Consolidation therapy resulted in
hematologic toxicity, but was not lethal in any of the eligible patients.
Patients receiving consolidation plus maintenance therapy experienced a
longer CR duration (40 wk) and disease-free survival at 2 yr (28%) than did
those patients receiving maintenance therapy alone (34 wk and 14%,
respectively). These differences are not statistically significant. These
results suggest that approaches to consolidation therapy employing reduced
doses of the induction therapy regimen can have, at best, only a small
benefit. For consolidation therapy to provide substantial improvement in CR
duration, intensive regimens with non-cross-resistant drugs will be
required.
Volume 63,
Issue 4,
pp. 843-847,
04/01/1984
Copyright © 1984 by The American Society of Hematology
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