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During the past 20 years, the EORTC Leukaemia Cooperative Group has performed four
large randomised clinical trials in patients with acute myeloblastic leukaemia (AML)
who were under the age of 60 years. Results of these studies support the use of intensive
remission induction schedules. Although consolidation therapy with high-dose or standard-dose
chemotherapy did not improve long-term survival substantially, marked improvements
were noted in patients receiving autologous or allogeneic bone marrow transplantation
(BMT), especially in those aged 45 years or younger. Preliminary results of study
AML-10, in which patients are receiving stem cell transplantation after a very intensive
induction course and a single high-dose consolidation regimen, are especially encouraging.
Improvements in the results of remission induction can be achieved by optimising the
use of existing antileukaemic agents, decreasing the number of fatal complications,
administering new chemotherapeutic or immunostimulatory agents, and making use of
early allogeneic stem cell transplantation. Improved consolidation may be achieved
by repeated administration of high-dose chemotherapy or by autologous BMT or transplantation
with autologous peripheral blood stem cells. Prevention of relapse following BMT may
be enhanced by the administration of immunomodulatory agents, such as interleukin-2
or linomide. Better definition of prognostic groups in AML may make possible the recruitment
of more homogeneous patient populations for clinical trials and facilitate the development
of individualised treatment regimens that will be associated with increased long-term
survival. To encourage advanced research in leukaemia, the EORTC and the Italian Leukaemia
Group (GIMEMA) are now establishing a network of molecular and cytogenetic laboratories
throughout Western Europe.
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© 1997 Published by Elsevier Inc.
