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dc.contributor.authorAbrahamsson, Jonas
dc.contributor.authorForestier, Erik
dc.contributor.authorHeldrup, Jesper
dc.contributor.authorJahnukainen, Kirsi
dc.contributor.authorJonsson, Olafur G
dc.contributor.authorLausen, Birgitte
dc.contributor.authorPalle, Josefine
dc.contributor.authorZeller, Bernward
dc.contributor.authorHasle, Henrik
dc.date.accessioned2011-04-15T11:11:05Z
dc.date.available2011-04-15T11:11:05Z
dc.date.issued2011-01-20
dc.date.submitted2011-04-15
dc.identifier.citationJ. Clin. Oncol. 2011, 29(3):310-5en
dc.identifier.issn1527-7755
dc.identifier.pmid21149663
dc.identifier.doi10.1200/JCO.2010.30.6829
dc.identifier.urihttp://hdl.handle.net/2336/128153
dc.descriptionPurpose: 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.en
dc.language.isoenen
dc.publisherAmerican Society of Clinical Oncologyen
dc.relation.urlhttp://dx.doi.org/10.1200/JCO.2010.30.6829en
dc.subject.meshAdolescenten
dc.subject.meshAntineoplastic Combined Chemotherapy Protocolsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshDrug Administration Scheduleen
dc.subject.meshDrug Monitoringen
dc.subject.meshDrug Toxicityen
dc.subject.meshFemaleen
dc.subject.meshFinlanden
dc.subject.meshGranulocyte Colony Stimulating Factor, Recombinanten
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshIdarubicinen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshLeukemia, Myeloid, Acuteen
dc.subject.meshMaleen
dc.subject.meshRemission Inductionen
dc.subject.meshRisk Assessmenten
dc.subject.meshScandinaviaen
dc.subject.meshSurvival Analysisen
dc.titleResponse-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rateen
dc.typeArticleen
dc.contributor.departmentInstitution of Clinical Sciences, Department of Pediatrics, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden. jonas.abrahamsson@vgregion.seen
dc.identifier.journalJournal of clinical oncology : official journal of the American Society of Clinical Oncologyen


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