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233 pts were evaluable for efficacy. Baseline characteristics of the pts were well balanced in both arms. The median progression-free survival (PFS) was of 30 m in the sequential and 32 m in the alternating arm (p>0,5). The median overall survival (OS) has been reached in the sequential arm (64m) whilst has not been reached yet in the alternating arm (63% at 5y) (p>0,5). 95 patients (41%) achieved >CR (49 and 46 patients in the sequential and alternating arms, respectively). Pts who achieved >CR had a significantly longer PFS (median of 45 m) as compared with pts who didn’t (median of 22,3 m) (HR: 0,32; p<0.0001). This translated into a benefit in OS: 73% of pts that achieved >CR remain alive at 5 years whilst the median OS was of 49 m for patients that didn’t achieve CR (HR: 0,34; p<0,0001). No differences were observed between the sequential and alternating arms. Minimal residual disease MRD was evaluated in 83 out of the 95 pts who achieved >CR. In 46 of them (55%) cells were undetectable with a sensitivity threshold of 10^-5, and were considered as MRD-ve patients. These pts displayed a significantly longer PFS (median not reached) as compared to MRD+ve pts (median PFS of 40m) (HR: 0.32; p=0,006) as well as significantly longer OS (HR: 0.26; p=0.012). FISH was available in  174 patients: 32 (18%) were considered high-risk (t(4;14), t(14;16) or del 17p). Outcomes were inferior but not significantly different between the high- and standard-risk groups in terms of PFS (26 m vs. 33 months (p=0.11)). The achievement of >CR completely overcome the adverse prognosis of the presence of high-risk cytogenetic abnormalities with a median PFS of 47 m and 50 m in the high and standard-risk subgroup, respectively (p>0.5). This effect was also evident when MRD negativity  was achieved. In terms of OS, the outcome for both high and standard risk subgroup of pts was superimposable during the first 20 months but the curves separated since this point, resulting in a median OS of 40m and 63m (p=0,001), respectively. This effect was maintained for pts that achieved >CR including MRD negativity.