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dc.contributor.authorKarlsson, Lene
dc.contributor.authorForestier, Erik
dc.contributor.authorHasle, Henrik
dc.contributor.authorJahnukainen, Kirsi
dc.contributor.authorJónsson, Ólafur G
dc.contributor.authorLausen, Birgitte
dc.contributor.authorNorén Nyström, Ulrika
dc.contributor.authorPalle, Josefine
dc.contributor.authorTierens, Anne
dc.contributor.authorZeller, Bernward
dc.contributor.authorAbrahamsson, Jonas
dc.date.accessioned2017-10-27T13:56:10Z
dc.date.available2017-10-27T13:56:10Z
dc.date.issued2017-08
dc.date.submitted2017
dc.identifier.citationOutcome after intensive reinduction therapy and allogeneic stem cell transplant in paediatric relapsed acute myeloid leukaemia. 2017, 178 (4):592-602 Br. J. Haematol.en
dc.identifier.issn1365-2141
dc.identifier.pmid28439893
dc.identifier.doi10.1111/bjh.14720
dc.identifier.urihttp://hdl.handle.net/2336/620329
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractGiven that 30-40% of children with acute myeloid leukaemia (AML) relapse after primary therapy it is important to define prognostic factors and identify optimal therapy. From 1993 to 2012, 543 children from the Nordic countries were treated according to two consecutive protocols: 208 children relapsed. The influence of disease characteristics, first line treatment, relapse therapy and duration of first remission on outcome was analysed. Second complete remission (CR2) was achieved in 146 (70%) patients. Estimated 5-year overall survival (OS5y ) was 39 ± 4% for the whole group and 43 ± 4% for the 190 patients given re-induction therapy, of whom 76% received regimens that included fludarabine, cytarabine (FLA) ± anthracyclines, 18% received Nordic Society for Paediatric Haematology and Oncology (NOPHO) upfront blocks and 5% received other regimens. Late relapse ≥1 year from diagnosis, no allogeneic stem cell transplantation (SCT) in first remission and core binding factor AML were independent favourable prognostic factors for survival. For the 128 children (124 in CR2) that received SCT as consolidation therapy after relapse, OS5y was 61 ± 5%. Four of 19 children (21%) survived without receiving SCT as part of relapse therapy. Our data show that intensive re-induction followed by SCT can give cure rates of 40% in children with relapsed AML.
dc.description.sponsorshipSwedish Childrens' Cancer Foundation Vastra Gotaland County Council (ALF project)en
dc.language.isoenen
dc.publisherWileyen
dc.relation.urlhttp://onlinelibrary.wiley.com/doi/10.1111/bjh.14720/epdfen
dc.rightsArchived with thanks to British journal of haematologyen
dc.subjectBráðahvítblæðien
dc.subjectBörnen
dc.subjectStofnfrumuígræðslaen
dc.subjectLífslíkuren
dc.subjectPED12en
dc.subject.meshAdolescenten
dc.subject.meshAntineoplastic Combined Chemotherapy Protocolsen
dc.subject.meshBiomarkers, Tumoren
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshChromosome Aberrationsen
dc.subject.meshCore Binding Factorsen
dc.subject.meshFemaleen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshLeukemia, Myeloid, Acuteen
dc.subject.meshLeukemic Infiltrationen
dc.subject.meshMaleen
dc.subject.meshPrognosisen
dc.subject.meshRecurrenceen
dc.subject.meshRemission Inductionen
dc.subject.meshRisk Factorsen
dc.subject.meshStem Cell Transplantationen
dc.subject.meshSurvival Analysisen
dc.subject.meshTreatment Outcomeen
dc.titleOutcome after intensive reinduction therapy and allogeneic stem cell transplant in paediatric relapsed acute myeloid leukaemia.en
dc.typeArticleen
dc.contributor.department[ 1 ] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Paediat, Gothenburg, Sweden Show the Organization-Enhanced name(s) [ 2 ] Umea Univ, Dept Clin Sci, Paediat, Umea, Sweden Show the Organization-Enhanced name(s) [ 3 ] Aarhus Univ, Hosp Skejby, Dept Paediat, Aarhus, Denmark [ 4 ] Childrens Hosp, Div Haematol Oncol & Stem Cell Transplantat, Helsinki, Finland Show the Organization-Enhanced name(s) [ 5 ] Landspitali Univ Hosp, Childrens Hosp, Hringbraut, Reykjavik, Iceland Show the Organization-Enhanced name(s) [ 6 ] Univ Copenhagen, Rigshosp, Dept Paediat & Adolescent Med, Copenhagen, Denmark Show the Organization-Enhanced name(s) [ 7 ] Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden Show the Organization-Enhanced name(s) [ 8 ] Toronto Gen Hosp, Univ Hlth Network, Dept Pathobiol & Lab Med, Toronto, ON, Canada Show the Organization-Enhanced name(s) [ 9 ] Oslo Univ Hosp, Dept Paediat, Oslo, Norwayen
dc.identifier.journalBritish journal of haematologyen
dc.rights.accessNational Consortium - Landsaðganguren
html.description.abstractGiven that 30-40% of children with acute myeloid leukaemia (AML) relapse after primary therapy it is important to define prognostic factors and identify optimal therapy. From 1993 to 2012, 543 children from the Nordic countries were treated according to two consecutive protocols: 208 children relapsed. The influence of disease characteristics, first line treatment, relapse therapy and duration of first remission on outcome was analysed. Second complete remission (CR2) was achieved in 146 (70%) patients. Estimated 5-year overall survival (OS5y ) was 39 ± 4% for the whole group and 43 ± 4% for the 190 patients given re-induction therapy, of whom 76% received regimens that included fludarabine, cytarabine (FLA) ± anthracyclines, 18% received Nordic Society for Paediatric Haematology and Oncology (NOPHO) upfront blocks and 5% received other regimens. Late relapse ≥1 year from diagnosis, no allogeneic stem cell transplantation (SCT) in first remission and core binding factor AML were independent favourable prognostic factors for survival. For the 128 children (124 in CR2) that received SCT as consolidation therapy after relapse, OS5y was 61 ± 5%. Four of 19 children (21%) survived without receiving SCT as part of relapse therapy. Our data show that intensive re-induction followed by SCT can give cure rates of 40% in children with relapsed AML.


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