Acute myelogenous leukemia: recent advances in therapy

Results of treatment of AML have improved over the last decade. With modern remission induction chemotherapy, most patients achieve complete remission. The median remission duration is now 1 to 2 years, and a substantial fraction of patients achieve long-term disease-free survival. Bone marrow transplantation provides an improved antileukemic effect compared with chemotherapy alone, and it is the treatment of choice for selected groups of patients. The major limitation is the risk of transplant-related mortality. Most patients are not currently eligible for bone marrow transplants because of advanced age or lack of a histocompatible donor. Autologous marrow transplantation may be effective in selected setting, but this remains investigational at present. Substantial improvement in results of treatment of AML requires the development of new and effective chemotherapeutic agents that are non-cross-resistant with available drugs. Results of bone marrow transplantation may substantially improve if innovative measures to prevent major complications are successful.