Pediatric acute myeloid leukemias treatment: current scientific view

Махачева, Ф. А.; Валиев, Т. Т.

doi:10.17650/1818-8346-2020-15-1-10-27

Onkogematologiâ

2020

DOI: 10.17650/1818-8346-2020-15-1-10-27

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Pediatric acute myeloid leukemias treatment: current scientific view

Ф. А. Махачева

Т. Т. Валиев

Abstract: The results of treatment of acute myeloid leukemias (AML) in children remain unsatisfactory. Modern therapeutic programs with hematopoietic stem cell transplantation allow us to get 5-year overall survival rate of 65 % in primary patients. For patients with relapses or refractory AML, 5-year overall survival is about 35 %.This article presents the possibilities of chemotherapy and hematopoietic stem cell transplantation in the treatment of AML. The possibilities of epigenetic, immune, and cellular therapy are … Show more

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2023

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Cited by 2 publications

References 85 publications

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Treatment of pediatric relapsed and refractory acute myeloid leukemia

Махачева

Валиев

2023

Onkogematologiâ

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Background. Despite the modern therapy programs including hematopoietic stem cell transplantation, the treatment outcomes for children with acute myeloid leukemia (AML) remain unsatisfactory. The 5‑year overall survival rate is about 70 %. The 5‑year overall survival rate for patients with relapsed and refractory AML is 2 times lower (about 35 %). The treatment failure rate in primary AML and unsatisfactory results in relapsed and refractory AML make it necessary to optimize therapy protocols.Aim was a long-term retro- and prospective analysis of clinical and laboratory characteristics and treatment outcomes in patients with relapsed and refractory forms of AML.Materials and methods. This article presents the treatment results of 54 patients from 1 to 18 years of age, with relapsed and refractory AML treated at the N. N . Blokhin National Medical Research Center of Oncology from 1997 to 2022.Results. A comparison of 5 different programs revealed that patients who received second remission induction with the FLA + FLA scheme had 81.8 % of response (complete or partial) achievement. Analysis of the results in achievement the second remission in patients received epigenetic agents (azacytidine, decitabine, valproic and all-trans retinoid acids) with second-line chemotherapy found that treatment response rate was 100 % (n = 27), in contrast to patients received only second-line chemotherapy (n = 27) – 81.5 % (p = 0.003). The best treatment results were in group of patients whose treatment included epigenetic agents and allogenic hematopoietic stem cell transplantation after second remission induction – 5‑year overall survival was 51.3 ± 9.7 %.Conclusion. Intensive polychemotherapy with fludarabine- and cytarabine-containing regiments with following allogeneic hematopoietic stem cell transplantation and epigenetic agents are current trend and pathogenetically based approach for relapsed and refractory pediatric AML. Probable, the definition of the role and place of targeted drugs (gemtuzumab ozogamicin) could continue the advances in treatment of such unfavorable patient group.

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Treatment of pediatric relapsed and refractory acute myeloid leukemia

Махачева

Валиев

2023

Onkogematologiâ

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Gamma-resonance method for the diagnosis of leukemia

2023

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Background. The modern concept of acute leukemia therapy involves stratification of patients into prognostic risk groups and a differentiated approach to treatment based on prognostic factors. However, antitumor treatment, including cytostatics, targeted agents, immunotherapy, cellular technologies, is not always highly effective, especially in patients with a poor prognosis. The development of new high-tech diagnostic methods and the refinement of leukemia prediction models remain an urgent clinical task.Aim. To demonstrate the fundamental capabilities of the nuclear gamma resonance method in the early diagnosis of leukemia.Materials and methods. The blood of 1 healthy man and 5 patients of different genders and ages with leukemia was examined. Gamma-resonance (Mossbauer) spectra of iron nuclei in their blood were analyzed.Results. Significant differences in the parameters of the spectra of 57Fe nuclei in the blood of both healthy men and patients of different genders and ages were revealed.Conclusion. Nuclear gamma-resonance spectroscopy at the atomic-nuclear level reveals the influence of cancer cells on the state of iron nuclei and, consequently, on the state of blood. This method can be used both for early diagnosis of leukemia and for assessing the population of tumor cells after achieving cytological remission in leukemia.

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Pediatric acute myeloid leukemias treatment: current scientific view

Cited by 2 publications

References 85 publications

Treatment of pediatric relapsed and refractory acute myeloid leukemia

Treatment of pediatric relapsed and refractory acute myeloid leukemia

Gamma-resonance method for the diagnosis of leukemia

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