COMPLICATIONS ASSOCIATED WITH AMLTREATMENT BY 7+3 AND 7+3+VP16 SCHEDULES
Addition of VP16 to the chemotherapy protocol "7+3" in prognostically unfavourable adult AML group (differential therapy) significantly improves treatment results CR rate and survival (Markina I.G., 2000). For several last years we apply differential therapy in high risk AML group based on clinico haematological, morpho cytochemical, immunophenotypic and cytogenetic prognostic factors. This leads to the improvement of treatment results of adult AML in prognostically unfavourable group. We compared the frequency of different complications in "7+3" vs "7+3+VP16" treatment schedules. There was lower frequency of infections in "7+3+VP16group" (77% vs 63%), in particular, pneumonias (54,3% vs 25,7%), at the same time the frequency of tonsillitis rises from 14,3% to 31,4%. There were no any differences in gastrointestinal toxicities. Cardio toxi city was lower in VP16 group — 30,5% and 13,8%. Use of VP 16 leads to somewhat increase in hepatotoxicity, and to significant increase in nephrotoxicity (13,8% vs 38,8%). The data to our mind confirm usefulness of differential increasing of VP 16 in programme treatment of adult AML based on clinico haematological, mopho cytochemical, immunophenotypic and cytogenetic signs of unfavorable prognosis.