ABSTRACT
The therapeutic determinants comprise different treatment options like prolonged maintenance chemotherapy, shorter intensified chemotherapy, differentiation inducers, hematopoietic growth factors, autologous and allogeneic bone marrow transplantation. Using matched-pair analysis in the AMLCG 1985 trial (38) allogeneic transplantation produced significantly higher 5 year disease free survival than chemotherapy in the control group. Thus, allogeneic transplantation in first remission remains as an open option. Its postponement to remission requires further investigation as does the role of transplantation in the context of prognostic factors. Karyotype analysis can clearly distinguish between favorable and unfavorable chromosome abnormalities. Recently abnormal fusion genes generated by the chromosomal rearrangements and translocations allow to detect and monitor the specific abnormalities at high sensitivity. Genotypes defined by specific chromosome abnormalities and fusion genes are reflected in part by specific morphological subtypes that also represent prognostic factors closely corresponding to their specific genotypes.
