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Favorable outcome in infants with AML after intensive first- and second-line treatment: an AML-BFM study group report.

Abstract：

:Infants <1 year of age have a high prevalence of prognostically unfavorable leukemias and a presumed susceptibility to treatment-related toxicities. A total of 125 infants with acute myeloid leukemia (AML) were treated in studies AML-BFM-98 (n = 59) and -2004 (n = 66). Treatment regimens of both studies were comparable, consisting of intensive induction followed by four courses (mainly high-dose cytarabine and anthracyclines). Allogeneic-hematopoietic stem-cell-transplantation (allo-HSCT) in 1st remission was optional for high-risk (HR) patients. Most infants (120/125=96%) were HR patients according to morphological, cytogenetic/molecular genetic and response criteria. Five-year overall survival was 66 ± 4%, and improved from 61 ± 6% in study-98 to 75 ± 6% in study-2004 (P(logrank) 0.14) and event-free survival rates were 44 ± 6% and 51 ± 6% (P(logrank) 0.66), respectively. Results in HR infants were similar to those of older HR children (1-<2- or 2-<10-year olds, P(logrank) 0.90 for survival). Survival rates of HSCT in 1st remission, initial partial response and after relapse were high (13/14, 2/8 and 20/30 patients, respectively). The latter contributes to excellent 5-year survival after relapse (50±8%). Despite more severe infections and pulmonary toxicities in infants, treatment-related death rate was identical to that of older children (3%). Our data indicate that intensive frontline and relapse AML treatment is feasible in infants, toxicities are manageable, and outcome is favorable.

journal_name

Leukemia

journal_title

Leukemia

authors

Creutzig U,Zimmermann M,Bourquin JP,Dworzak MN,Kremens B,Lehrnbecher T,von Neuhoff C,Sander A,von Stackelberg A,Schmid I,Starý J,Steinbach D,Vormoor J,Reinhardt D

doi

10.1038/leu.2011.267

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

654-61

issue

4

eissn

0887-6924

issn

1476-5551

pii

leu2011267

journal_volume

26

pub_type

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