Clinical studies of acute myeloid leukemia in the Japan Adult Leukemia Study Group.

Acute myeloid leukemia (AML) is the most common adult leukemia in Japan. The treatment for AML consists of induction, consolidation, and maintenance therapies. To improve outcomes in the treatment of AML, the Japan Adult Leukemia Study Group has conducted six studies in AML patients aged 15-64 years since 1987. In AML201 study, IDR (12 mg/m(2)/day for 3 days) or DNR (50 mg/m(2)/day for 5 days) in combination with Ara-C (100 mg/m(2)/day continuous infusion for 7 days) was established as the standard induction therapy, and four courses of combination chemotherapy using non-cross-resistant agents for non-core binding factor (CBF) AML or three courses of high-dose Ara-C for CBF AML was established as the standard consolidation therapy. The AML97 study showed that allo-HSCT from an HLA-identical sibling donor reduced relapse incidence and improved disease-free survival (DFS), but did not significantly impact overall survival (OS) in poor or intermediate risk patients. Despite these studies by JALSG, only about one-third of AML patients remain free of disease for more than 7 years. The JALSG is now conducting the AML209 study to adapt individual therapies according to genetic alterations.