Idarubicin Plus Behenoyl Cytarabine and 6-thioguanine Compares Favorably with Idarubicin Plus Cytarabine-based Regimen for Children with Previously Untreated Acute Myeloid Leukemia: 10-Year Retrospective, Multicenter Study in Korea

Lee, Dae Hyoung; Chung, Nak Gyun; Cho, Bin; Kim, Hack Ki; Kang, Hyoung Jin; Shin, Hee Young; Ahn, Hyo Seop; Yoo, Keon Hee; Sung, Ki Woong; Koo, Hong Hoe; Kook, Hoon; Hwang, Tai Ju; Im, Ho Joon; Seo, Jong Jin; Park, Hyeon Jin

doi:10.3346/jkms.2010.25.1.9

Cited by 6 publications

(5 citation statements)

References 19 publications

(32 reference statements)

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“…In present study, we performed double UCBT in pediatric patients including AML in first CR according to the guideline of Korean National Health Insurance Review & Assessment which allow UCBT for patients without appropriate donor in first CR. Although there is some controversy about the role of alternative donor transplantation including UCBT for AML in first CR [14][15][16][17], pediatric AML patients without matched related donor routinely undergo alternative donor transplantation in first CR in Korea as the outcome of chemotherapy was not satisfactory [18], the allogeneic transplantation is associated with improved outcomes in first CR [17], and promising results of alternative donor transplantation were demonstrated in pediatric AML with the development of transplantation techniques [16,19].…”

Section: Discussionmentioning

confidence: 99%

Double umbilical cord blood transplantation for children and adolescents

et al. 2010

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Umbilical cord blood transplantation (UCBT) with two units has been conducted with promising results in adults to overcome the limitation of low cell numbers. In an attempt to improve the outcomes, double UCBT was performed in children and adolescents. Sixty-one patients, including 44 acute leukemia, and 17 other hematologic diseases, received double UCBT. Donor-type engraftment achieved in 82% of patients. Except one patient with persistent mixed chimerism of two units, other 49 patients showed dominancy of one unit and only the CFU-GM was significant factor influencing dominancy. The event-free survival (EFS) of leukemia and other hematologic disease were 59% and 53%, respectively, and the EFS of acute leukemia patients who received transplant in first or second CR (68.6%) was significantly better than in those with advanced disease (22.2%) (P = 0.007). Among the factors influencing outcomes, low cell dose difference between two units (TNC difference/TNC of large unit <15%) were associated with higher TRM, relapse, and lower EFS. Double UCBT was a promising modality of transplant in children and adolescence. However, engraftment and other results were not so satisfactory yet. To improve the outcomes, development of new selection guideline, probably including cell dose difference between two units and technology to enhance engraftment and reduce transplantation-related mortality are warranted.

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Section: Discussionmentioning

confidence: 99%

Double umbilical cord blood transplantation for children and adolescents

et al. 2010

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“…The KSBRM regimen (N=76), and the Korean AML 2012 regimen (N=15) were the treatment protocols used. The KSBRM regimen is based on idarubicin plus N4-behenoyl-1-β-D-arabinofuranosyl cytosine (BHAC) chemotherapy [ 12 ]; the Korean AML 2012 regimen is a double-induction regimen consisting of idarubicin (IDA) or mitoxantrone plus cytarabine based chemotherapy.…”

Section: Methodsmentioning

confidence: 99%

“…Partial remission (PR) was defined as a BM with 5–15% blast cells and evidence of regeneration of normal hematopoietic cells. Patients who did not achieve CR or PR and who survived after the first 6 weeks of treatment were defined as non-responders (NR) [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

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Improvement of treatment outcome over 2 decades in children with acute myeloid leukemia

et al. 2018

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BackgroundThe prognosis of pediatric acute myeloid leukemia (AML) has recently improved. This study aimed to describe the epidemiology, changes in treatment strategies, and improvement of outcomes in Gwangju-Chonnam children with AML over 2 decades.MethodsMedical records of 116 children with newly diagnosed AML were retrospectively reviewed for demographic characteristics, prognostic groups including cytogenetic risks, treatment protocols, and survival rates over the periods between 1996 and 2005 (Period I, N=53), and 2006 and 2015 (Period II, N=38).ResultsThe annual incidence of AML has decreased with reduced pediatric population. The 5-year Kaplan-Meier (K-M) estimated overall survival (OS) and event-free survival (EFS) rates in 110 AML patients were 53.2±5.1% and 43.8±5.1%, respectively. The 5-year OS rate significantly improved during period II (70.3±7.0%) as compared to that during period I (40.0±6.8%) (P =0.001). The 5-year OS was not significantly different among cytogenetic risk groups (P =0.11). Fifty-eight patients underwent hematopoietic stem cell transplantation (HSCT). The K-M 5-year estimated survival for transplanted patients was 53.7±7.0%, while that for chemotherapy-only patients was 30.1±9.1% (P =0.014). Among the prognostic factors, treatment modality was the only independent factor. The chemotherapy-only group had a relative risk of 2.06 for death compared with the transplantation group (P=0.015).ConclusionThe survival of Korean children with AML has improved to a level comparable with that of developed countries over 2 decades, owing to a change in induction strategy, better supportive care with economic growth, refinement of HSCT techniques including a better selection of patients based on prognostic groups, and stem cell donor selection.

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“…Thirty-six of the 37 patients received the same induction and 2-4 cycles of consolidation chemotherapy in accordance with the standard protocol (16). If cycles of consolidation therapy were more than four sessions, patients received maintenance therapies before HSCT.…”

Section: Methodsmentioning

confidence: 99%

Growth after Hematopoietic Stem Cell Transplantation in Children with Acute Myeloid Leukemia

et al. 2013

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Previous studies have shown that hematopoietic stem cell transplantation (HSCT) may result in growth impairment. The purpose of this study was to evaluate the growth during 5 yr after HSCT and to determine factors that influence final adult height (FAH). We retrospectively reviewed the medical records of acute myeloid leukemia (AML) patients who received HSCT. Among a total of 37 eligible patients, we selected 24 patients who began puberty at 5 yr after HSCT (Group 1) and 19 patients who reached FAH without relapse (Group 2). In Group 1, with younger age at HSCT, sex, steroid treatment, hypogonadism and hypothyroidism were not significantly associated with growth impairment 5 yr after HSCT. History of radiotherapy (RT) significantly impaired the 5 yr growth after HSCT. Chronic graft-versus-host disease (cGVHD) only temporarily impaired growth after HSCT. In Group 2, with younger age at HSCT, steroid treatment and hypogonadism did not significantly reduce FAH. History of RT significantly reduced FAH. Growth impairment after HSCT may occur in AML patients, but in patients without a history of RT, growth impairment seemed to be temporary and was mitigated by catch-up growth.

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Idarubicin Plus Behenoyl Cytarabine and 6-thioguanine Compares Favorably with Idarubicin Plus Cytarabine-based Regimen for Children with Previously Untreated Acute Myeloid Leukemia: 10-Year Retrospective, Multicenter Study in Korea

Cited by 6 publications

References 19 publications

Double umbilical cord blood transplantation for children and adolescents

Double umbilical cord blood transplantation for children and adolescents

Improvement of treatment outcome over 2 decades in children with acute myeloid leukemia

Growth after Hematopoietic Stem Cell Transplantation in Children with Acute Myeloid Leukemia

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