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[Prediction of resistance to remission induction in acute leukemia in adult].

Twenty-two patients with adult acute non-lymphocytic leukemia treated with intensive combination chemotherapy between November 1975 and April 1982 were retrospectively analyzed to see if we could find useful clinical parameters which could predict those patients who, after failing their initial treatment cycle, would respond to subsequent cycles of the same regimen. Three groups of patients were identified. Eight patients achieved complete remission with one cycle of chemotherapy; seven patients achieved complete remission with a second cycle of the same regimen and seven patients did not respond. Marrow studies performed approximately 3 weeks following the first cycle of therapy were analyzed. Patients who subsequently responded to the regimen differed from non-responders in the residual blasts percentage in the marrow obtained 20-24 days after the initiation of the first cycle. Patients who responded to a second cycle had 11-36% blasts (mean 24%), while non-responders had 35-96% blasts (mean 66%) (p less than 0.01). No patients with more than 40% blasts in their bone marrow achieved complete remission. We concluded that patients with more than 40% blasts in their bone marrow 20-24 days after the initiation of the first cycle of the chemotherapy regimens used should receive an alternate regimen for a second cycle of induction therapy.