Treatment of Acute Myelogenous Leukemia

To the Editor: The report by Zittoun et al. (Jan. 26 issue)¹ on a comparison of allogeneic or autologous transplantation and chemotherapy for acute myelogenous leukemia (AML) illustrates a flaw in the study design that is common in trials of treatment for acute leukemia and that limits the clinical usefulness of the conclusions that are drawn. In the trial, all patients with histocompatible donors were assigned to the allogeneic-transplantation group and none were randomly assigned to the other two groups. This design is appropriate for studying the end point of duration of the first remission or of disease-free survival, but.