A comparison of marrow transplantation with chemotherapy for adults with XXXX of poor prognosis in first complete remission.

@entity1 @entity1778 @entity981 @entity3052
From July 1980 to November 1985, 109 @entity1 with acute myelogenous and @entity981 who had reached a complete remission (CR) following induction treatment were assigned to a study comparing marrow transplantation with chemotherapy as a postremission treatment. Sixty-nine @entity1 did not have a human leukocyte antigen (HLA)-identical donor, and therefore served as chemotherapy controls; 40 @entity1 had HLA-identical donors, and therefore were assigned to the transplant arm. Of these, 23 were transplanted in first remission and 17 were not. Ten of these 17 were subsequently transplanted in relapse. Initially, only @entity1 with poor prognosis determined by a predictive model were entered into the study. Subsequently, @entity1 with moderately poor prognosis were admitted. Comparing the chemotherapy group with the @entity1 transplanted in first CR, significant control of @entity1778 relapse in transplanted @entity1 was seen in the subgroup with @entity3052 ( @entity3052 ) (P less than .1), and @entity981 ( @entity981 ) (P less than .01), in the poor (P = .01) and intermediate subgroup (P = .01), and in the good-prognostic groups (P = .05). The survival was affected significantly in only the poor and intermediate subgroups. The use of predictive models might help to select @entity1 for whom bone marrow transplantation is appropriate in first remission and those for whom bone marrow transplantation can be left as the initial treatment of relapse. Predictive models could further be helpful in comparing studies performed at different transplant centers.
