Increased dose and dose intensity of post-remission therapy have been shown to clearly improve outcome in AML. In 1988, Cassileth et al. demonstrated that low-dose cytosine arabinoside (Ara-C) maintenance CT was superior to no post-remission therapy in first remission AML.5 Indeed, all patients who did not receive further therapy relapsed, with a median time to progression of only 4 months. Subsequent studies established a dose response effect of post-remission cytarabine among patients under the age of 60, ultimately leading to 4-year continuous complete

Table 35.1 Factors that affect relapse risk following autologous transplantation for leukemia

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