PURPOSE: To evaluate the early treatment response in children with acute myeloid leukemia (AML) using a response-guided induction strategy that includes idarubicin in the first course. PATIENTS AND METHODS: All Nordic children with AML younger than 15 years (n = 151) were treated on the Nordic Society for Pediatric Hematology and Oncology (NOPHO) AML 2004 protocol. After the first course of idarubicin, cytarabine, etoposide, and 6-thioguanin, patients with good response were allowed hematologic recovery before the second course, whereas patients with a poor (≥ 15% blasts) or intermediate (5% to 14.9% blasts) were recommended to proceed immediately with therapy. Patients not in remission after the second course received fludarabine, cytarabine, and granulocyte colony-stimulating factor. Poor responders received allogeneic stem-cell transplantation (SCT) as consolidation. RESULTS: Seventy-four percent of patients had good response, 17% had intermediate response, and 7% had poor response after the first course. The overall remission frequency was 97.4%, with 92% in remission after the second course. The rate of induction death was 1.3%. Patients with an intermediate response had a lower event-free survival of 35% compared with good (61%) and poor responders (82%). CONCLUSION: The NOPHO-AML 2004 induction strategy gives an excellent remission rate with low toxic mortality in an unselected population. Outcome is worse in patients with intermediate response but may be improved by intensifying consolidation in this group using SCT.
PURPOSE: To evaluate the early treatment response in children with acute myeloid leukemia (AML) using a response-guided induction strategy that includes idarubicin in the first course. PATIENTS AND METHODS: All Nordic children with AML younger than 15 years (n = 151) were treated on the Nordic Society for Pediatric Hematology and Oncology (NOPHO) AML 2004 protocol. After the first course of idarubicin, cytarabine, etoposide, and 6-thioguanin, patients with good response were allowed hematologic recovery before the second course, whereas patients with a poor (≥ 15% blasts) or intermediate (5% to 14.9% blasts) were recommended to proceed immediately with therapy. Patients not in remission after the second course received fludarabine, cytarabine, and granulocyte colony-stimulating factor. Poor responders received allogeneic stem-cell transplantation (SCT) as consolidation. RESULTS: Seventy-four percent of patients had good response, 17% had intermediate response, and 7% had poor response after the first course. The overall remission frequency was 97.4%, with 92% in remission after the second course. The rate of induction death was 1.3%. Patients with an intermediate response had a lower event-free survival of 35% compared with good (61%) and poor responders (82%). CONCLUSION: The NOPHO-AML 2004 induction strategy gives an excellent remission rate with low toxic mortality in an unselected population. Outcome is worse in patients with intermediate response but may be improved by intensifying consolidation in this group using SCT.
Authors: Ditte J A Løhmann; Jonas Abrahamsson; Shau-Yin Ha; Ólafur G Jónsson; Minna Koskenvuo; Birgitte Lausen; Josefine Palle; Bernward Zeller; Henrik Hasle Journal: Haematologica Date: 2016-07-28 Impact factor: 9.941
Authors: Martin G Sauer; Peter J Lang; Michael H Albert; Peter Bader; Ursula Creutzig; Matthias Eyrich; Johann Greil; Bernd Gruhn; Wolfgang Holter; Thomas Klingebiel; Bernhard Kremens; Heiko von der Leyen; Christine Mauz-Körholz; Roland Meisel; Kirsten Mischke; Ingo Müller; Charlotte M Niemeyer; Christina Peters; Christine Pohler; Dirk Reinhardt; Birgit Burkhardt; Paul G Schlegel; Ansgar S Schulz; Johanna Schrum; Petr Sedlacek; Brigitte Strahm; Wilhelm Woessmann; Rupert Handgretinger; Martin Zimmermann; Arndt Borkhardt Journal: Leukemia Date: 2019-10-02 Impact factor: 11.528
Authors: Menachem Bitan; Wensheng He; Mei-Jie Zhang; Hisham Abdel-Azim; Mouhab Fakhreddine Ayas; Bella Bielorai; Paul A Carpenter; Mitchell S Cairo; Miguel Angel Diaz; John T Horan; Sonata Jodele; Carrie L Kitko; Kirk R Schultz; Morris Kletzel; Kimberly A Kasow; Leslie E Lehmann; Parinda A Mehta; Nirali Shah; Michael A Pulsipher; Tim Prestidge; Adriana Seber; Shalini Shenoy; Ann E Woolfrey; Lolie C Yu; Stella M Davies Journal: Blood Date: 2014-01-16 Impact factor: 22.113
Authors: Chi Keung Cheng; Tsz Ki Kwan; Chi Ying Cheung; Kitty Ng; Pei Liang; Suk Hang Cheng; Natalie P H Chan; Rosalina K L Ip; Raymond S M Wong; Vincent Lee; Chi Kong Li; Sze Fai Yip; Margaret H L Ng Journal: Haematologica Date: 2012-10-12 Impact factor: 9.941