Results of the AIEOP AML 2002/01 multicenter prospective trial for the treatment of children with acute myeloid leukemia.

Abstract

We evaluated the outcome of 482 children with acute myeloid leukemia (AML) enrolled in the Associazione Italiana di Ematologia e Oncologia Pediatrica AML 2002/01 trial. Treatment was stratified according to risk group; hematopoietic stem cell transplantation (HSCT) was used in high-risk (HR) children. Patients with core binding factor leukemia achieving complete remission (CR) after the first induction course were considered standard risk (SR; 99 patients), whereas the others (n = 383) were assigned to the HR group. Allogeneic (ALLO) or autologous (AUTO) HSCT was employed, respectively, in 141 and 102 HR patients after consolidation therapy. CR, early death, and induction failure rates were 87%, 3%, and 10%, respectively. Relapse occurred in 24% of patients achieving CR. The 8-year overall survival (OS), event-free survival (EFS), and disease-free survival (DFS) were 68%, 55%, and 63%, respectively. OS, EFS, and DFS for SR and HR patients were 83%, 63%, and 66% and 64%, 53%, and 62%. DFS was 63% and 73% for HR patients given AUTO-HSCT and ALLO-HSCT, respectively. In multivariate analysis, risk group, white blood cell >100 × 10(9)/L at diagnosis, and monosomal karyotype predicted poorer EFS. Risk-oriented treatment and broad use of HSCT result in a long-term EFS comparing favorably with previously published studies on childhood AML.

• Authors: Andrea Pession, Riccardo Masetti, Carmelo Rizzari, Maria Caterina Putti, Fiorina Casale, Franca Fagioli, Matteo Luciani, Luca Lo Nigro, Giuseppe Menna, Concetta Micalizzi, Nicola Santoro, Anna Maria Testi, Marco Zecca, Andrea Biondi, Martina Pigazzi, Sergio Rutella, Roberto Rondelli, Giuseppe Basso, Franco Locatelli, AIEOP AML Study Group
• Journal: Blood (Blood) Vol. 122 Issue 2 Pg. 170-8 (Jul 11 2013) ISSN: 1528-0020 [Electronic] United States
• PMID: 23673857 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)

Topics

• Adolescent
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Child
• Child, Preschool
• Consolidation Chemotherapy
• Female
• Follow-Up Studies
• Hematopoietic Stem Cell Transplantation
• Humans
• Induction Chemotherapy
• Infant, Newborn
• Leukemia, Myeloid, Acute (mortality, therapy)
• Male
• Recurrence
• Transplantation, Autologous
• Transplantation, Homologous
• Treatment Outcome