Journal Article

Treatment and long-term results in children with acute myeloid leukaemia treated according to the AIEOP AML protocols

Rizzari, C, Fagioli, F, Pession, A, Testi, A M, Basso, G, Locatelli, F, Rondelli, R, De Stefano, P

2005

Overview

Since 1982, four consecutive studies on childhood acute myeloid leukaemia (AML) (namely LAM-82, -87, -87M and -92) have been conducted in Italy by the Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP) group. The induction therapy of the first three studies consisted of daunorubicin and cytarabine structured in a 3+7 backbone. In the most recent protocol (LAM92), patients received two induction courses including idarubicin, cytarabine and etoposide. Patients with acute promyelocytic leukaemia (20% of diagnoses) were included in LAM-87 and 87M studies. Postremissional therapy significantly changed over time, with an ever-increasing role given to stem cell transplantation (SCT). The long-term outcome of patients enrolled in the LAM-82, 87 and 87M studies was comparable, whereas that of children treated according to LAM-92 study was significantly better ( P <0.005). Either allogeneic or autologous SCT was employed as consolidation therapy in more than 75% of cases enrolled in this latter study. Patients enrolled in the LAM-92 study were stratified in standard and high-risk groups with different outcome (67 vs 47%, respectively, P =0.04). Altogether, the results obtained in these four studies have permitted a progressive refinement of treatment, contributing to the structure of the ongoing LAM-2002 protocol that stratifies patients according to the presence of definite genetic anomalies and response to induction therapy.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: Acute Disease / Acute myeloid leukemia / Adolescent / Anomalies / Antineoplastic Protocols - standards / Autografts / Cancer Research / Child / Child, Preschool / Children / Critical Care Medicine / Cytarabine / Daunorubicin / Etoposide / Female / Follow-Up Studies / Hematology / Hematopoietic Stem Cell Transplantation / Humans / Induction therapy / Infant / Infant, Newborn / Intensive / Internal Medicine / Leukemia / Leukemia, Myeloid - mortality / Leukemia, Myeloid - therapy / Male / Medicine / Medicine & Public Health / Oncology / original-manuscript / Patients / Pediatrics / Remission Induction - methods / Risk groups / Stem cell transplantation / Stem cells / Survival Analysis / Therapy / Transplantation / Treatment Outcome