High-dose therapy in acute leukemia

Carmelo Carlo-Stella, Lina Mangoni, Cecilia Caramatti, Camillo Almici, Vittorio Rizzoli

Research output: Contribution to journalArticlepeer-review

Abstract

The use of intensive induction chemotherapy, primarily with combinations of an anthracycline and cytarabine, allows complete remission rates of greater than 70% in patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). However, with currently available standard-dose therapy, only 20% of young adults are cured. In order to substantially increase the cure rate, adequate post-remission therapeutic strategies are mandatory. Three different therapeutic options are currently available: (i) dose-intensified chemotherapy; (ii) allogeneic stem cell transplantation; (iii) autologous stem cell transplantation. These therapeutic options should be carefully evaluated according to prognostic information, including cytogenetic and molecular abnormalities as well as phenotypic characterization. Randomized trials of intensive postremission therapy have now confirmed improved leukemia-free survival with the use of allogeneic or autologous transplantation. Autologous transplantation appears to be the most promising treatment modality in AML. Improved preparative regimens and purging techniques may be critical factors in determining the effectiveness of autologous transplantation in AML patients. In adult ALL, the role and optimal methods of stem cell transplantation are still under investigation.

Original languageEnglish
Pages (from-to)61-67
Number of pages7
JournalLeukemia and Lymphoma
Volume26
Issue numberSUPPL. 1
Publication statusPublished - 1997

Keywords

  • Acute leukemia
  • Chemotherapy
  • Prognostic factors
  • Stem cell transplantantion

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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