Treatment of acute myeloid leukemia in children: experience from a tertiary care hematology centre in India.

Abstract:

OBJECTIVE:To assess the treatment and outcome of children with acute myeloid leukemia. The Primary objectives were to assess remission rates, treatment related toxicity and disease free survival. Secondary objective was to assess prognostic factors associated with poor outcome. METHODS:A retrospective analysis of all treated patients with acute myeloid leukemia, less than 18 year of age from Sept 2005 to Aug 2009 was done. Clinical laboratory, treatment and follow up records retrieved to calculate remission rate, treatment related toxicity, disease free survival and poor prognostic factors. RESULTS:This analysis included thirty five patients (male : female; 23:12), twenty seven (77.1%) achieved remission after one 3 + 7 induction and seven required two inductions. High dose cytosine arabinoside consolidation was given in thirty one patients while one underwent allogenic stem cell transplantation. Two patients died during chemotherapy (TRM- 5.7%), two did not complete the therapy, seventeen relapsed (48.5%) with 80% of relapses occurring within first year of remission and no relapse occurred after 2 years. Fourteen patients are in remission (40%, follow up 5-54 months) and cumulative median disease free survival is of 13 months. CONCLUSIONS:The present data suggests that 3 + 7 induction, followed by high dose cytarabine consolidation has low treatment related toxicity and resource utilization; however, relapse free survival is inferior to more intensive regimens, highlighting the need to intensify chemotherapy regimen once the treatment related mortality has been minimized.

journal_name

Indian J Pediatr

authors

Gupta N,Seth T,Mishra P,Mahapatra M,Rathi S,Kapoor R,Agarwal N,Kumar S,Saxena R

doi

10.1007/s12098-010-0300-1

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

1211-5

issue

10

eissn

0019-5456

issn

0973-7693

journal_volume

78

pub_type

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