Abstract:
PURPOSE:To determine whether, after very intensive induction and consolidation therapy in childhood AML, further maintenance therapy (MT) confers any advantage. PATIENTS AND METHODS:Three hundred-nine children with previously untreated AML were registered in the LAME 89/91 protocol. This three-cycle intensive regimen included an induction phase (mitoxantrone plus cytarabine) and, for non-allografted patients, two consolidation courses, one containing timed-sequential high-dose cytarabine, asparaginase and amsacrine. In the LAME 89 study, patients were given an additional MT consisting of mercaptopurine and cytarabine for 18 months. In the LAME 91 trial, patients were randomized to be given or not MT after consolidation therapy. RESULTS:Out of 309 patients, 276 (90%) achieved a complete remission. The overall survival (OS) and event-free survival at 6 years for all patients were 60% +/- 6% and 48% +/- 6%, respectively. For the complete responders after consolidation therapy, the 5-year OS was significantly better in patients randomized for no further treatment than in patients randomized for MT (81% +/- 13% vs 58% +/- 15%; p = 0.04) whilst the 5-year disease-free survival was not significantly different (60% +/- 19% vs 50% +/- 15%; p = 0.25). The improvement of OS in MT-patients appeared to be related to a higher salvage rate after relapse. CONCLUSION:Over 50% of patients can be cured of AML in childhood. In the context of a very short and drug-intensive regimen, low-dose MT, owing to the lack of improvement in disease control and the worsening of survival, should not be recommended. Over the past 20 years, the outcome of acute myeloid leukemia (AML) in children has improved substantially. In the eighties, complete remission (CR) was achieved in nearly 90% of patients but event-free survival (EFS) was poor. Myeloablative therapy followed by allogenic bone-marrow transplantation (allo BMT) from an HLA-identical sibling was demonstrated, in our experience, to be the treatment of choice for improving DFS in children with AML in first remission. The major issue was how best to maintain complete remission for patients without an HLA sibling donor. Whereas several groups continued to include low-dose MT and others decided to omit it, in 1991, our group undertook a prospective randomized trial (LAME 91 protocol), the main aim of which was to assess the efficacy of MT in addition to an intensive induction and consolidation chemotherapy. The main results have been published previously and are now updated and described in a higher number of patients.
journal_name
Ann Hematoljournal_title
Annals of hematologyauthors
Perel Y,Auvrignon A,Leblanc T,Michel G,Vannier JP,Dalle JH,Gandemer V,Schmitt C,Mèchinaud F,Lamagnere JP,Piguet Ch,Couillaud G,Pautard B,Baruchel A,Leverger G,Group LAME.,French Society of Pediatric Hematology and Immunoldoi
10.1007/s00277-004-0850-2subject
Has Abstractpub_date
2004-01-01 00:00:00pages
S116-9eissn
0939-5555issn
1432-0584journal_volume
83 Suppl 1pub_type
临床试验,杂志文章,随机对照试验abstract::Secondary central nervous system (CNS) involvement in diffuse large B-cell lymphoma (DLBCL) includes an isolated CNS relapse or CNS involvement with systemic disease progression. This rare but fatal clinical problem still remains a therapeutic dilemma in the management of DLBCL. However, there are limited data about i...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-010-1104-0
更新日期:2011-05-01 00:00:00
abstract::Primary non-Hodgkin's lymphoma of bone (PLB) is a rare entity. We present three new cases and a review of the literature. If PLB is suspected radiologically, the diagnosis must be confirmed by open biopsy. Histopathologically, PLB usually represents diffuse large B-cell lymphoma or lymphoma of the follicular center ty...
journal_title:Annals of hematology
pub_type: 杂志文章,评审
doi:10.1007/s00277-003-0674-5
更新日期:2003-07-01 00:00:00
abstract::The incidence of multiple myeloma (MM) has increased in the last 20 years, particularly in middle and low-middle income countries. Access to diagnostic and prognostic tests and the availability of effective care is highly variable globally. Latin America represents 10% of the world population, distributed in countries...
journal_title:Annals of hematology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00277-020-03983-x
更新日期:2020-05-01 00:00:00
abstract::There is increasing evidence for the role of chronic antigenic stimulation (CS) in the development of cancer. Clinical data, however, are rare as is the information on outcome. In this study, the occurrence of chronic infections (CI) and autoimmune diseases (AI) in patients with malignant lymphoma at diagnosis was ass...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-011-1178-3
更新日期:2011-08-01 00:00:00
abstract::Recombinant human granulocyte colony-stimulating factor (rhG-CSF) and erythropoietin (rhE-PO) were used to treat ten patients with myelodysplastic syndromes (MDS). None of the patients showed a favorable response in erythrocyte and platelet counts following 10 weeks' treatment, although favorable responses in neutroph...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/BF01834360
更新日期:1994-04-01 00:00:00
abstract::The most common causes of morbidity and mortality in myeloproliferative neoplasms (MPN) are thrombotic and hemorrhagic complications. The JAK2V617F mutation, commonly found in MPN, correlates with several clinical and laboratory characteristics even if the relevance of JAK2V617F allele burden in the natural history of...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-017-3040-8
更新日期:2017-08-01 00:00:00
abstract::Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma with heterogeneous outcomes. Progression or relapse of FL within 2 years (so-called POD24) after diagnosis is associated with a poor outcome for patients treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisone) in clinica...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-020-04025-2
更新日期:2020-07-01 00:00:00
abstract::In this paper we report a rare association of a splenic marginal zone B-cell lymphoma with villous lymphocytes and a T-cell large granular lymphocytic leukemia coexpressing CD4 and CD8 as well as CD56 and CD57 natural killer-associated markers in an asymptomatic patient investigated because of an occasional finding of...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s002770100369
更新日期:2001-11-01 00:00:00
abstract::Patients with malignancy often present with a variety of coagulation abnormalities which may ultimately lead to recurrent arterial and venous thromboses. Recently the presence of antiphospholipid antibodies in cancer patients has been proposed as one of the potential mechanisms promoting hypercoagulability. Here we re...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-002-0565-1
更新日期:2002-12-01 00:00:00
abstract::Nondeletional hereditary persistence of fetal hemoglobin (nd-HPFH), a rare hereditary condition resulting in elevated levels of fetal hemoglobin (Hb F) in adults, is associated with promoter mutations in the human fetal globin (HBG1 and HBG2) genes. In this paper, we report a novel type of nd-HPFH due to a HBG2 gene p...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-008-0643-0
更新日期:2009-06-01 00:00:00
abstract::It is often difficult for standard blood banks in Korea to supply adequate amounts of blood for patients with rare phenotype. Moreover, the definition of a blood in need is ambiguous, and much remains to be learned. In this study, we determined the prevalence of various red blood cell (RBC) antigens from a donor viewp...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-016-2645-7
更新日期:2016-05-01 00:00:00
abstract::Hodgkin lymphoma (HL), a disease of mostly young patients, also peaks in the elderly. Despite the profound improvement in the outcome of young patients, in the elderly, 5-year progression-free survival (PFS) rates are under 70%. Interim PET-CT (iPET) is known to be highly predictive for PFS in young HL patients, but i...
journal_title:Annals of hematology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00277-019-03686-y
更新日期:2019-07-01 00:00:00
abstract::Renal failure is one of the worst complications occurring in multiple myeloma (MM) patients. It does not affect survival if reverted by a prompt chemotherapy before the damage becomes irreversible; therefore, the early diagnosis of renal dysfunction is crucial. High and low molecular weight urinary proteins have prove...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-003-0699-9
更新日期:2003-08-01 00:00:00
abstract::In a large proportion of patients with mild bleeding disorders (MBDs) no diagnosis can be established by routine coagulation tests. We investigated whether alterations in plasma clot properties account for MBDs of unknown cause. Ninety-five patients with MBDs of unknown origin and 98 age- and sex-matched healthy contr...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-015-2399-7
更新日期:2015-08-01 00:00:00
abstract::The general objective of this study was to evaluate the risks of agranulocytosis and aplastic anemia in relation to drug use. Other potential risk factors, including history of infectious mononucleosis, were also evaluated. In an international population-based case-control study, cases of agranulocytosis and aplastic ...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/BF01695866
更新日期:1993-10-01 00:00:00
abstract::Uptake and biochemical and biological effects of antisense oligodeoxynucleotides (ODN) specific for c-abl and bcr genes were studied in normal immature myeloid cells. CD34-positive cells were purified by positive and negative selection and cultured in liquid culture for 7 days. These cells were then incubated with ODN...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/BF00641311
更新日期:1996-02-01 00:00:00
abstract::Co-inheritance of triplicated α-genes can alter the clinical and hematological phenotypes of β-thalassemias. We evaluated the phenotypic diversity and transfusion requirements in β-thalassemia heterozygotes, homozygotes, and normal individuals with associated α-gene triplication. Clinical and hematological evaluation ...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-015-2479-8
更新日期:2015-12-01 00:00:00
abstract::Spontaneous splenic rupture is a rare, though life-threatening complication of some hematological malignancies and is even more infrequent as the initial symptom of acute lymphoblastic leukemia. We describe the fourth case, to our knowledge, of acute lymphoblastic leukemia presenting as splenic rupture, and for the fi...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/BF01727419
更新日期:1994-03-01 00:00:00
abstract::Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for relapsed, advanced, and otherwise incurable non-Hodgkin's lymphomas (NHL) suggested by the existence of a graft-versus-lymphoma effect. The main complications are graft-versus-host disease and infections. We performed a retrospec...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-017-2934-9
更新日期:2017-05-01 00:00:00
abstract::In 1989, a prospective randomized multicenter study was initiated in order to determine the safety and efficacy of oral clodronate in myeloma patients. The primary objective of this long-term trial is to evaluate whether supportive clodronate is able to prevent or retard the progression of bone disease and reduce the ...
journal_title:Annals of hematology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/BF01697625
更新日期:1993-03-01 00:00:00
abstract::Autoantibody against erythrocytes has occasionally been observed in patients with de novo acute myelocytic leukemia (AML). However, it is not clear whether this autoantibody in AML patients induces frank hemolysis (autoimmune hemolytic anemia, AIHA), as seen in lymphoid neoplasms. We present two de novo AML patients w...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/BF00663016
更新日期:1996-01-01 00:00:00
abstract::Patients with primary refractory or relapsed acute myeloid leukemia (AML) who undergo intensive salvage chemotherapy carry a high risk of treatment failure due to infectious complications and early relapses. The study presented here assessed the effect of granulocyte colony-stimulating factor (G-CSF) on the duration o...
journal_title:Annals of hematology
pub_type: 临床试验,杂志文章
doi:10.1007/s002770050425
更新日期:1998-09-01 00:00:00
abstract::The objective of this study is to compare and evaluate the diagnostic value of hereditary spherocytosis (HS) by three screening tests, comparing mean spherical corpuscular volume (MSCV) to mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), and flow cytometric osmotic fragility test. Perip...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-014-2270-2
更新日期:2015-05-01 00:00:00
abstract::The main purpose of this report is to focus on the importance of an accurate etiologic diagnosis of gastrointestinal complications during chemotherapy for acute myeloid leukemia, taking into account that a syndrome characterized by bowel wall thickening associated with diarrhea and abdominal pain may have etiologies d...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-003-0755-5
更新日期:2004-03-01 00:00:00
abstract::Interstitial pneumonia (IP) is a lethal complication in lymphoma patients undergoing chemotherapy. A total of 2212 consecutive patients diagnosed with lymphoma between 2009 and 2014 were enrolled in the present study. IP was defined as diffuse pulmonary interstitial infiltrate found on computed tomography scans. IP wa...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-017-3157-9
更新日期:2018-01-01 00:00:00
abstract::Cancer incidence in patients with recurrent unprovoked venous thromboembolism (VTE) is much higher than after a first event, but the incidence of myeloproliferative neoplasms (MPN) in this situation is still unknown. We tested for JAK2V617F and calreticulin mutants, 372 DNA samples of patients treated for (VTR). Among...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-016-2853-1
更新日期:2017-03-01 00:00:00
abstract::Relapse remains one of the major obstacles in Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) even after allogeneic hematopoietic stem cell transplantation. The persistence of leukemia-propagating cells (LPCs) may lead to the recurrence of Ph+ALL. Using a xenograft assay, LPCs enrichment in the ...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-018-3253-5
更新日期:2018-05-01 00:00:00
abstract::We analyzed the prognostic factors for a successful mobilization and peripheral blood stem cell collection in a series of 57 consecutive patients with multiple myeloma (MM); a new scoring system to predict an adequate mobilization in this subset of patients was also constructed. A total of 221 aphereses were performed...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s002770100351
更新日期:2001-10-01 00:00:00
abstract::Follicular lymphoma (FL) is a low-grade lymphoma that is usually characterized by generalized lymphadenopathy. Extranodal invasion by FL generally involves the bone marrow, skin, and duodenum; splenic infiltration often occurs in the advanced stages. However, primary splenic FL is very rare. Hence, few studies have be...
journal_title:Annals of hematology
pub_type: 临床试验,杂志文章
doi:10.1007/s00277-017-3139-y
更新日期:2017-12-01 00:00:00
abstract::Recently, it was shown that glycoproteins with N-glycans close to the NH(2) terminus can directly enter the calnexin/calreticulin cycle and bypass BiP binding. This should allow efficient secretion of glycoproteins such as factor VIII (FVIII) whose secretion is negatively affected by BiP interaction. Examination of th...
journal_title:Annals of hematology
pub_type: 杂志文章
doi:10.1007/s00277-007-0380-9
更新日期:2008-02-01 00:00:00