The best therapy for people with acute myelogenous leukemia (AML) in first remission is controversial. Options include postremission chemotherapy, a bone marrow transplant (HLA-identical sibling or autotransplant) or chemotherapy followed by a transplant at relapse. Four large cooperative group trials address this issue. In this review design and implementation of these trials is considered. Whether data from these trials will answer the questions of the best therapy for AML in first remission, is focused upon.