Treatment stratification based on initial in vivo response in acute myeloid leukaemia in children without Down's syndrome: results of NOPHO-AML trials.

2.50
Hdl Handle:
http://hdl.handle.net/2336/15496
Title:
Treatment stratification based on initial in vivo response in acute myeloid leukaemia in children without Down's syndrome: results of NOPHO-AML trials.
Authors:
Lie, Sverre O; Abrahamsson, Jonas; Clausen, Niels; Forestier, Erik; Hasle, Henrik; Hovi, Liisa; Jonmundsson, Gudmundur; Mellander, Lotta; Gustafsson, Göran
Citation:
Br J Haematol. 2003, 122(2):217-25
Issue Date:
1-Jul-2003
Abstract:
Three consecutive protocols for childhood acute myeloid leukaemia (AML) have been used in the Nordic countries since 1984: the Nordic Society for Paediatric Haematology and Oncology (NOPHO)-AML84 was of moderate intensity, NOPHO-AML88 of high intensity with upfront loading and aggressive consolidation. NOPHO-AML93 utilized the same treatment blocks as NOPHO-AML88, but after the first block those children with a hypoplastic non-leukaemic bone marrow were allowed to recover from aplasia. Poor responders received intensified induction therapy. Between January 1993 and December 2000, 219 children without Down's syndrome were entered on NOPHO-AML93. Compared with NOPHO-AML88, the event-free survival (EFS) at 7 years increased from 41% to 49% (P = 0.06) and 7-year overall survival increased from 47% to 64% (P < 0.01). Toxic death during induction was reduced from 10% to 3%. Survival was similar in patients receiving stem cell transplantation or chemotherapy only in first remission. The major prognostic factors in NOPHO-AML93 were response to therapy and cytogenetics. A total of 67% of patients achieved remission after the first induction course and showed an EFS of 56% compared with 35% in those not in remission (P < 0.01). Cytogenetic results were obtained in 95% of patients. Patients with t(9;11) (p22;q23) (n = 16) experienced a significantly better EFS (86%) than other cytogenetic groups. The overall outcome was improved by employing the previous toxic protocol with different timings, and through individualizing therapy according to the initial response of the patient.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=10193404&site=ehost-live

Full metadata record

DC FieldValue Language
dc.contributor.authorLie, Sverre O-
dc.contributor.authorAbrahamsson, Jonas-
dc.contributor.authorClausen, Niels-
dc.contributor.authorForestier, Erik-
dc.contributor.authorHasle, Henrik-
dc.contributor.authorHovi, Liisa-
dc.contributor.authorJonmundsson, Gudmundur-
dc.contributor.authorMellander, Lotta-
dc.contributor.authorGustafsson, Göran-
dc.date.accessioned2007-12-21T16:33:23Z-
dc.date.available2007-12-21T16:33:23Z-
dc.date.issued2003-07-01-
dc.date.submitted2007-11-21-
dc.identifier.citationBr J Haematol. 2003, 122(2):217-25en
dc.identifier.issn0007-1048-
dc.identifier.pmid12846889-
dc.identifier.doi10.1046/j.1365-2141.2003.04418.x-
dc.identifier.urihttp://hdl.handle.net/2336/15496-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractThree consecutive protocols for childhood acute myeloid leukaemia (AML) have been used in the Nordic countries since 1984: the Nordic Society for Paediatric Haematology and Oncology (NOPHO)-AML84 was of moderate intensity, NOPHO-AML88 of high intensity with upfront loading and aggressive consolidation. NOPHO-AML93 utilized the same treatment blocks as NOPHO-AML88, but after the first block those children with a hypoplastic non-leukaemic bone marrow were allowed to recover from aplasia. Poor responders received intensified induction therapy. Between January 1993 and December 2000, 219 children without Down's syndrome were entered on NOPHO-AML93. Compared with NOPHO-AML88, the event-free survival (EFS) at 7 years increased from 41% to 49% (P = 0.06) and 7-year overall survival increased from 47% to 64% (P < 0.01). Toxic death during induction was reduced from 10% to 3%. Survival was similar in patients receiving stem cell transplantation or chemotherapy only in first remission. The major prognostic factors in NOPHO-AML93 were response to therapy and cytogenetics. A total of 67% of patients achieved remission after the first induction course and showed an EFS of 56% compared with 35% in those not in remission (P < 0.01). Cytogenetic results were obtained in 95% of patients. Patients with t(9;11) (p22;q23) (n = 16) experienced a significantly better EFS (86%) than other cytogenetic groups. The overall outcome was improved by employing the previous toxic protocol with different timings, and through individualizing therapy according to the initial response of the patient.en
dc.language.isoenen
dc.publisherBlackwell Scientific Publicationsen
dc.relation.urlhttp://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=10193404&site=ehost-liveen
dc.subject.meshAcute Diseaseen
dc.subject.meshAntimetabolites, Antineoplasticen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshChromosomes, Human, Pair 11en
dc.subject.meshChromosomes, Human, Pair 9en
dc.subject.meshClinical Protocolsen
dc.subject.meshCytarabineen
dc.subject.meshCytogenetic Analysisen
dc.subject.meshDisease-Free Survivalen
dc.subject.meshDrug Administration Scheduleen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshLeukemia, Myeloiden
dc.subject.meshMaleen
dc.subject.meshPatient Selectionen
dc.subject.meshPrognosisen
dc.subject.meshRemission Inductionen
dc.subject.meshStem Cell Transplantationen
dc.subject.meshSurvival Rateen
dc.subject.meshTranslocation, Geneticen
dc.titleTreatment stratification based on initial in vivo response in acute myeloid leukaemia in children without Down's syndrome: results of NOPHO-AML trials.en
dc.typeArticleen
dc.contributor.departmentDepartment of Paediatrics, University Hospital, Rikshospitalet, Oslo, Norway.en

Related articles on PubMed

All Items in Hirsla are protected by copyright, with all rights reserved, unless otherwise indicated.