Acute myeloblastic leukemia secondary to myelodysplasia (MDS-AML): a comparison of remission induction with three drugs versus standard two drugs induction

The prognosis of patients with myelodysplastic syndromes evolved in overt acute myeloid leukemia (MDS-AML) is generally very poor. With the standard anthracycline and cytosine arabinoside (AraC) combination currently employed in “de novo” AML, less than 50% of patients achieve complete remission (CR), with a median disease free survival (DFS) <= 10 months (Iw3). Since 1990’s, many efforts have been made to improve the outcome of this group of patients. According to the general statement concerning chemotherapy that “more is better”, an intensification with the addition of a third drug to standard induction treatment has been evaluated in several trials (4-6). In this study, we compare retrospectively patients with MDS-AML who received a standard 2-drugs induction versus patients who received such therapy but with a 3-drugs induction which included the addition of etoposide.