ackground : Although substantial progress in the treatment of acute myelogenous
leukemia (AML) has produced complete remission (CR) in 60% to 80% of patients receiving
induction chemotherapy, the median remission duration is about 12 months and only 205 to
35% of patietns undergoing consolidation chemotherapy achieve long-term disease-free
survival (DFS).
Allogeneic bone marrow transplantation (BMT) in first remission has resulted in a 45% to
65% overall survival rate.
Methods ; From July 1986 to December 1991, 92 patients with AML who had reached a
CR following induction chemotherapy were assigned to a retrospective study comparing
allogeneic BMT with consolidation chemotherapy as a postremission treatment. The results
in 16 patients,m aged 16 to 40 years, who underwent a HLA matched BMT in first remission
were compared with those in 41 patients, age-matched, lacked an HLA-identical sibling,
trated with one or more cycles of conslidation chemotherapy.
Results ;
1) After a median follow-up of 21 months (3∼57 months), the acturaial DFS at 4 years
was significantly higher in the transplantation group than in the chemotheraphy group (66% v
27%; p<0.05), and the actuarial probability of leukemic replape was considerably lower in the
group treated with BMT (24% v 69%; p<0.0005).
2) The median survival and DFS has not yet been reached for BMT group, and 17
months, 13 months, respectively for chemotherapy group.
3) Treatment-related mortality was similar in both groups (13% in BMT group, 10% in
chemotherapy group).
Conclustion ; Our results show that allogeneic BMT appears to be superior to
consolidation chemotherapy and offers the best chance of long-term DFS in patients with
AML in first remission. It will therefore be appropriate postremission treatment startegy to
undergo allogeneic BMT for patients with AML in first remission under the age of 40 who
have an HLA-indentical sibling donor.
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