Over the past decade, optimal chemotherapy in patients with acute non lymphoblastic leukemia (AnLL) has increased the remission (CR) rate (from 50 to 64%), median CR duration (from 10 to 13 months) and responders' survival (from 15 to 19 months). Younger age and normal cytogenetics are favourable factors in achieving CR. However, no parameter is unequivocally important in determining CR duration, including the type of post-induction chemotherapy (for which cyclic maintenance and/or consolidation therapy with the same or other drugs used for inducing CR have been employed). Most studies exclude a relevant number of patients from induction and/or from post-induction chemotherapy and/or results evaluation for different reasons including old age, poor general conditions, non-optimal treatment and a previous myelodysplasia. These exclusions lower the CR rate and survival of the general AnLL population. There are doubts as to whether the percentage of long-survivors, and possibly cured patients (about 10-15% of those optimally treated) has increased over the past. Allogeneic bone marrow transplantation (BMT) in first CR is superior to chemotherapy in prolonging survival of patients less than 25 years of age, who become long-survivors in over 50% of cases. Clear proof that it is advantageous in older patients is still lacking. Autologous BMT (ABMT) seems promising, since about 40% of patients transplanted in first CR are alive at 3 years, but a greater number of patients needs to be examined for a longer time in order to ascertain its definitive role. Salvage chemotherapy remains unsatisfactory. In young patients, better results are being obtained with allogeneic BMT and, perhaps, with ABMT.
|Number of pages||18|
|Publication status||Published - 1987|
ASJC Scopus subject areas