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Comparison of three remission induction regimens and two postinduction
strategies for the treatment of acute nonlymphocytic leukemia: a cancer and
leukemia group B study
H Preisler, RB Davis, J Kirshner, E Dupre, F Richards , HC Hoagland, S Kopel, RN Levy, R Carey and P Schulman
Patients with acute nonlymphocytic leukemia were randomized to receive
remission induction therapy consisting of seven days of cytosine
arabinoside and three days of daunorubicin ("7 + 3") or to receive the same
regimen intensified by either the addition of 6-thioguanine or by extension
of the administration of cytosine arabinoside to ten days. Additionally,
all patients were randomized to receive or not to receive cotrimoxazole
antibacterial prophylaxis during the remission induction phase. Neither an
increase in intensity of chemotherapy nor the antibacterial prophylaxis
increased the remission rate above the 53% for patients treated with the
standard "7 + 3" regimen. The second part of this study addressed the issue
of the utility of long-term maintenance chemotherapy. To this end, patients
were randomized to discontinue all treatment after 8 months of maintenance
chemotherapy or to continue maintenance therapy for a total of 3 years.
Although there was a transient increase in the relapse rate for patients
who discontinued therapy, the proportion of long-term remitters was
identical in the two patient groups. Additionally, there is a suggestion of
a survival advantage for patients randomized to discontinue all therapy at
8 months.
Volume 69,
Issue 5,
pp. 1441-1449,
05/01/1987
Copyright © 1987 by The American Society of Hematology
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