Improved outcome after relapse in children with acute myeloid leukaemia
Open Access
- 23 November 2006
- journal article
- Published by Wiley in British Journal of Haematology
- Vol. 136 (2), 229-236
- https://doi.org/10.1111/j.1365-2141.2006.06419.x
Abstract
In the Nordic Society for Paediatric Haematology and Oncology paediatric study acute myeloid leukaemia (AML) 93, event‐free survival was 50% and overall survival was 66%, indicating that many patients were cured following relapse. Factors influencing outcome in children with relapsed AML were investigated. The study included all 146 children in the Nordic countries diagnosed with AML between 1988 and 2003, who relapsed. Data on disease characteristics and relapse treatment were related to outcome. Sixty‐six percentage achieved remission with survival after relapse (5 years) 34 ± 4%. Of 122 patients who received re‐induction therapy, 77% entered remission with 40 ± 5% survival. Remission rates were similar for different re‐induction regimens but fludarabine, cytarabine, granulocyte colony‐stimulating factor‐based therapy had low treatment‐related mortality. Prognostic factors for survival were duration of first complete remission (CR1) and stem cell transplantation (SCT) in CR1. In early relapse (<1 year in CR1), survival was 21 ± 5% compared with 48 ± 6% in late relapse. For children receiving re‐induction therapy, survival in early relapse was 29 ± 6% and 51 ± 6% in late. Patients treated in CR1 with SCT, autologous SCT or chemotherapy had a survival of 18 ± 9, 5 ± 5 and 41 ± 5%, respectively. Survival was 62 ± 6% in 64 children given SCT as part of their relapse therapy. A significant proportion of children with relapsed AML can be cured, even those with early relapse. Children who receive re‐induction therapy, enter remission and proceed to SCT can achieve a cure rate of 60%.Keywords
This publication has 20 references indexed in Scilit:
- Biology and management of relapsed acute myeloid leukaemiaBritish Journal of Haematology, 2005
- Treatment of relapsed acute myeloid leukemia after allogeneic bone marrow transplantation with chemotherapy followed by G-CSF-primed donor leukocyte infusion: a high incidence of isolated extramedullary relapseLeukemia, 2004
- Second transplant for acute and chronic leukemia relapsing after first HLA-identical sibling transplantBone Marrow Transplantation, 2004
- Outcome in Children With Relapsed Acute Myeloid Leukemia After Initial Treatment With the French Leucémie Aiquë Myéloïde Enfant (LAME) 89/91 Protocol of the French Society of Pediatric Hematology and ImmunologyJournal of Clinical Oncology, 2003
- Ex vivo drug resistance in childhood acute myeloid leukemia on relapse is not higher than at first diagnosisPediatric Blood & Cancer, 2003
- Impact of Addition of Maintenance Therapy to Intensive Induction and Consolidation Chemotherapy for Childhood Acute Myeloblastic Leukemia: Results of a Prospective Randomized Trial, LAME 89/91Journal of Clinical Oncology, 2002
- Multivariate analysis of prognostic factors in patients with refractory and relapsed acute myeloid leukemia undergoing sequential high-dose cytosine arabinoside and mitoxantrone (S-HAM) salvage therapy: relevance of cytogenetic abnormalitiesLeukemia, 2000
- 3 × 14 mg/m2 Idarubicin during induction: results of a pilot study in children with AMLLeukemia, 2000
- TruePublished by Springer Science and Business Media LLC ,1999
- Outcome for children with relapsed acute myeloid leukaemia following initial therapy in the Medical Research Council (MRC) AML 10 trialLeukemia, 1999