Advances in the Management of Acute Nonlymphocytic Leukemia

Ten years ago, less than one fourth of patients with acute nonlymphocytic leukemia (ANLL) (acute myelocytic, myelomonocytic erythroleukemia, and monocytic leukemia) achieved complete remission of their disease with conventional or experimental chemotherapy. Today, two thirds or more of patients with that disease will achieve complete remission and, perhaps more importantly, the median duration of complete remission has been substantially improved recently by a combined modality approach to maintenance therapy. The result of these advances is that median survival of all treated patients, and of patients who achieve complete remission in particular, has greatly improved. Important improvements in supportive care, chemotherapy, and immunotherapy have together resulted in justifiable optimism for the control of ANLL in the foreseeable future. SUPPORTIVE CAREInfection Prevention Infection during induction therapy resulting from granulocytopenia secondary to the disease and/or its therapy has claimed the lives of more than 25% of patients with ANLL before an adequate