FREDERICK R. APPELBAUM, M.D.; STEVE DAHLBERG, M.S.; E. DONNALL THOMAS, M.D.; C. DEAN BUCKNER, M.D.; MARTIN A. CHEEVER, M.D.; REGINALD A. CLIFT, F.I.M.L.S.; JOHN CROWLEY, Ph.D.; H. JOACHIM DEEG, M.D.; ALEXANDER FEFER, M.D.; PHILIP D. GREENBERG, M.D.; MARSHALL KADIN, M.D.; WALTER SMITH, M.D.; PATRICIA STEWART, M.D.; KEITH SULLIVAN, M.D.; RAINER STORB, M.D.; PAUL WEIDEN, M.D.
We compared the outcome of marrow transplantation with that of continued chemotherapy for adults with acute nonlymphoblastic leukemia who achieve a first remission. From May 1977 to July 1982, 111 consecutive adults (ages 17 to 50) with newly diagnosed acute nonlymphoblastic leukemia were treated with induction chemotherapy. Ninety patients (81%) had a complete remission. Forty-four remission patients had available donors: 33 received a transplant and 11 did not. Forty-six patients in remission without matched donors were treated with continued chemotherapy. Kaplan-Meier estimates of 5-year, disease-free survival from complete remission are 49% ± 18% for the transplant group and 20% ± 13% for the chemotherapy group. When compared to the chemotherapy group, patients undergoing transplantation had a higher risk of dying during the first 6 months after remission induction but a lower risk of dying thereafter. Within the transplant group, only age influenced survival. Within the chemotherapy group, a leukocyte count of greater than 10 000 mm3 at diagnosis, a French-American-British (FAB) Cooperative Group morphologic status of M-4, M-5, or M-6, and the presence of infection at diagnosis were all associated with shorter survival.
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APPELBAUM FR, DAHLBERG S, THOMAS ED, BUCKNER CD, CHEEVER MA, CLIFT RA, et al. Bone Marrow Transplantation or Chemotherapy After Remission Induction for Adults with Acute Nonlymphoblastic Leukemia: A Prospective Comparison. Ann Intern Med. 1984;101:581-588. doi: 10.7326/0003-4819-101-5-581
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Published: Ann Intern Med. 1984;101(5):581-588.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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