Aggressive chemotherapy in adult primary XXXX . A report on 29 cases.

@entity1 @entity29474 @entity2590 @entity62706 @entity236 @entity3894
Twenty-nine adult @entity1 with primary @entity2590 ( @entity2590 ) and an excess of @entity236 were treated by aggressive chemotherapy while still in @entity2590 phase (20 cases) or after progression to ANLL (9 cases). Median age was 47.5 (range 18-68). Twenty-eight @entity1 received a combination of @entity29474 and @entity62706 received High dose Ara C. Fourteen @entity1 (48%) achieved complete remission (CR), 5 (17%) were treatment failures (F) and 10 (35%) died during therapy induced @entity3894 (DA). Median disease free survival was 8.5 months. Median survival of the whole population was 6 months from the onset of treatment, and 17 months in @entity1 achieving CR. These results were significantly less favorable than those obtained at our institution in de novo ANLL with the same chemotherapy regimens. No statistically significant prognostic factors of treatment outcome emerged but @entity1 with normal cytogenetic findings seemed to have both a higher CR rate and longer remissions than @entity1 with abnormal karyotypes. @entity1 under 50 did not have higher CR rates than older @entity1 , although they had longer remissions (with 3 out of 6 CRs exceeding 2 years). Finally, treatment outcome and survival were identical in @entity1 treated in the @entity2590 phase and in those treated after progression to ANLL. Combination chemotherapy is a highly toxic approach in @entity2590 and essentially seems to benefit younger @entity1 with a normal karyotype, in whom some long remissions can be obtained.
