Eighty-six consecutive untreated adults with acute myelogenous leukemia were treated with a combination of Adriamycin, vincristine, prednisolone, Cytosine Arabinoside, and BCG. Complete remission was achieved in 39 (45%) patients; these patients were then allocated on an alternate basis to receive BCG and monthly chemotherapy with or without weekly irradiated allogeneic blast cells. The median duration of remission was eight months and was the same for both groups. The median survival of those achieving complete remission was 19 months compared with two months for those not achieving complete remission. Nine patients are still alive without relapse and five of these patients have been disease free for more than three years.
Cancer 46:2142-2148, 1980. T WAS DEMONSTRATED in the early 1970s that the I combination of Cytosine Arabinoside with either an anthracycline antibiotic' or 6-thioguanineI4 produced complete remission in approximately 50% of cases of acute myelogenous leukemia. A pilot study, carried out at the M.D. Anderson Hospital2' demonstrated that the combination of vincristine and prednisolone is also active in acute myelogenous leukemia (AML), producing 17% remissions in previously untreated cases. Encouraged by this finding. McCredie introduced a remission induction program combining vincristine, prednisolone. Adriamycin, and Cytosine Arabinoside with BCG."' Cytosine Arabinoside was given by continuous infusion because this method had been reported to be more effective than intravenous bolus injection.4.26 Preliminary reports indicated that this program resulted in a complete remission rate of 70% in adults under the age of 50: it was adopted at St. Bartholomew's Hospital in 1974.