Results of treatment of acute myeloid leukemia in adults

Sixty-five previously untreated patients (34 women, 31 men) with acute myelocytic leukemia, ranging in age from 15 to 71 (median 43) years, were treated for remission induction with 7-day courses of cytarabine (100 mg/m2/day continuous i.v. infusion) together with daunorubicin (45 mg/m2/day rapid i.v. injection) on days 1, 2 and 3. Supportive care consisted of broad spectrum antibiotics for fever in the presence of granulocytopenia and substitution of erythrocytes and platelets. The complete remission (CR) rate was 55.3%. The mean numbers of chemotherapy courses and days to achieve CR were 1.5 and 41, respectively. Sex and age appeared to have no effect on the remission rate. For remission maintenance, cyclic courses of cytarabine (i.v. 100 mg/m2 q 12 hr X 10) were given with each of four drugs, 6-thioguanine (p.o. 100 mg/m2 q 12 hr X 10), cyclophosphamide (i.v. 800 mg/m2 on day 1), CCNU (p.o. 100 mg on day 1) or daunorubicin (i.v. 45 mg/m2 on days 1 and 2) in rotational sequence. The median remission duration was 44 weeks, the median survival time for all patients 31 weeks, for those responding to therapy 74, and those not responding 8 weeks.