Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate
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 Socie...
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/128153 2023-05-15T16:51:28+02:00 Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate Abrahamsson, Jonas Forestier, Erik Heldrup, Jesper Jahnukainen, Kirsi Jonsson, Olafur G Lausen, Birgitte Palle, Josefine Zeller, Bernward Hasle, Henrik Institution of Clinical Sciences, Department of Pediatrics, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden. jonas.abrahamsson@vgregion.se 2011-04-15 http://hdl.handle.net/2336/128153 https://doi.org/10.1200/JCO.2010.30.6829 en eng American Society of Clinical Oncology http://dx.doi.org/10.1200/JCO.2010.30.6829 J. Clin. Oncol. 2011, 29(3):310-5 1527-7755 21149663 doi:10.1200/JCO.2010.30.6829 http://hdl.handle.net/2336/128153 Journal of clinical oncology : official journal of the American Society of Clinical Oncology Adolescent Antineoplastic Combined Chemotherapy Protocols Child Preschool Drug Administration Schedule Drug Monitoring Drug Toxicity Female Finland Granulocyte Colony Stimulating Factor Recombinant Humans Iceland Idarubicin Infant Newborn Leukemia Myeloid Acute Male Remission Induction Risk Assessment Scandinavia Survival Analysis Article 2011 ftlandspitaliuni https://doi.org/10.1200/JCO.2010.30.6829 2022-05-29T08:21:45Z 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. Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Journal of Clinical Oncology 29 3 310 315 |
institution |
Open Polar |
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Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
Adolescent Antineoplastic Combined Chemotherapy Protocols Child Preschool Drug Administration Schedule Drug Monitoring Drug Toxicity Female Finland Granulocyte Colony Stimulating Factor Recombinant Humans Iceland Idarubicin Infant Newborn Leukemia Myeloid Acute Male Remission Induction Risk Assessment Scandinavia Survival Analysis |
spellingShingle |
Adolescent Antineoplastic Combined Chemotherapy Protocols Child Preschool Drug Administration Schedule Drug Monitoring Drug Toxicity Female Finland Granulocyte Colony Stimulating Factor Recombinant Humans Iceland Idarubicin Infant Newborn Leukemia Myeloid Acute Male Remission Induction Risk Assessment Scandinavia Survival Analysis Abrahamsson, Jonas Forestier, Erik Heldrup, Jesper Jahnukainen, Kirsi Jonsson, Olafur G Lausen, Birgitte Palle, Josefine Zeller, Bernward Hasle, Henrik Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate |
topic_facet |
Adolescent Antineoplastic Combined Chemotherapy Protocols Child Preschool Drug Administration Schedule Drug Monitoring Drug Toxicity Female Finland Granulocyte Colony Stimulating Factor Recombinant Humans Iceland Idarubicin Infant Newborn Leukemia Myeloid Acute Male Remission Induction Risk Assessment Scandinavia Survival Analysis |
description |
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. |
author2 |
Institution of Clinical Sciences, Department of Pediatrics, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden. jonas.abrahamsson@vgregion.se |
format |
Article in Journal/Newspaper |
author |
Abrahamsson, Jonas Forestier, Erik Heldrup, Jesper Jahnukainen, Kirsi Jonsson, Olafur G Lausen, Birgitte Palle, Josefine Zeller, Bernward Hasle, Henrik |
author_facet |
Abrahamsson, Jonas Forestier, Erik Heldrup, Jesper Jahnukainen, Kirsi Jonsson, Olafur G Lausen, Birgitte Palle, Josefine Zeller, Bernward Hasle, Henrik |
author_sort |
Abrahamsson, Jonas |
title |
Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate |
title_short |
Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate |
title_full |
Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate |
title_fullStr |
Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate |
title_full_unstemmed |
Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate |
title_sort |
response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate |
publisher |
American Society of Clinical Oncology |
publishDate |
2011 |
url |
http://hdl.handle.net/2336/128153 https://doi.org/10.1200/JCO.2010.30.6829 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://dx.doi.org/10.1200/JCO.2010.30.6829 J. Clin. Oncol. 2011, 29(3):310-5 1527-7755 21149663 doi:10.1200/JCO.2010.30.6829 http://hdl.handle.net/2336/128153 Journal of clinical oncology : official journal of the American Society of Clinical Oncology |
op_doi |
https://doi.org/10.1200/JCO.2010.30.6829 |
container_title |
Journal of Clinical Oncology |
container_volume |
29 |
container_issue |
3 |
container_start_page |
310 |
op_container_end_page |
315 |
_version_ |
1766041579799183360 |