EFFECT OF LONG- AND SHORT-TERM MINICONSOLIDATION ON SURVIVAL OF PATIENTS WITH ACUTE MYELOGENOUS LEUKEMIA

A retrospective study was done on 130 AML patients treated in Shariati and Imam Hospitals in Tehran from 1991 to 1997 to investigate the value of three post-remission methods of treatment. All patients who were in complete remission (CR) (Group I) had been treated with ARA-C (300 mg/m2/day continuous infusion for 5 days) and Daunorubicine (45 mg/m2/day for 3 days) as induction and early consolidation therapy. Forty patients were treated by additional similar chemotherapy as second consolidation and no further treatment was offered. Fifty patients (Group II) were treated by ARA-C (120 mg/m2 subcutaneously for 5 days), Etoposide (120 mg/m2 on day one), and Mitoxantrone (12 mg/m2 on day one) on each successive month as short-term miniconsolidation. Forty patients (Group III) were treated similarly to Group II until relapse for up to two years as long-term miniconsolidation. There was no difference in the three groups regarding mean age and other prognostic factors. Treatment related mortality and morbidity were also similar. Median duration of disease-free survival (DFS) was 36 (3.5-68 with 95% CI), 17 (12.5-21.5) and 19 (14.7-23.3) months respectively in these three groups. In a 14- month median observation there was no difference in DFS and overall survival (OS) among the three groups (p=0.7). We concluded that short- or long-term miniconsolidation chemotherapy compared to standard treatment does not improve DFS and OS in AML patients.