Results of 58872 and 58921 trials in acute myeloblastic leukemia and relative value of chemotherapy vs allogeneic bone marrow transplantation in first complete remission: the EORTC Children Leukemia Group report

Abstract

. Out of 108 patients, 78% achieved complete remission (CR), and event-free survival (EFS) and survival rates (s.e., %) at 7 years were 40 (5) and 51% (6%), respectively. It indicated that mitoxantrone could be substituted for conventional anthracyclines in the treatment of childhood AML without inducing cardiotoxicity. The aim of the next EORTC 58921 trial was to compare the efficacy and toxicity of idarubicin vs mitoxantrone in initial chemotherapy courses, further therapy consisting of allogeneic bone marrow transplantation (alloBMT) in patients with an HLA-compatible sibling donor or chemotherapy in patients without a donor. Out of 177 patients, recruited between October 1992 and December 2002, 81% reached CR. Overall 7-year EFS and survival rates were 49 (4) and 62% (4%), respectively. Out of 145 patients who received the first intensification, 39 had a sibling donor. In patients with or without a donor, the 7-year disease-free survival (DFS) rate was 63 (8) and 57% (5%) and the 7-year survival rate was 78 (7) and 65% (5%), respectively. Patients with favorable, intermediate and unfavorable cytogenetic features had a 5-year EFS rate of 57, 45 and 45% and a 5-year survival rate of 89, 67 and 53%, respectively.

Improved treatment results for childhood acute myeloid leukemia in Taiwan

“…The 5-year EFS of 5474.4% achieved in studies TPOG-AML-97A, TPOG-APL-97, and TPOG-APL-2001 were at least comparable to the 31-54% attained in studies conducted in other developed countries during the same era, [25][26][27][28][29][30][31][32][33][34][35][36][37] and the treatment was well tolerated. However, like in the Dutch Childhood Oncology Group experience, a more effective, but less toxic, therapy and better supportive care guidelines for childhood AML are still needed.…”

“…[25][26][27][28][29][30][31][32][33][34][35][36][37] The challenge now is to extend the benefits of contemporary AML therapy to larger numbers of patients in developing countries, where fewer than 10% children with acute leukemia are receiving protocol-based therapy. 59 …”

Identification and characterization of novel AML1-ETO fusion transcripts in pediatric t(8;21) acute myeloid leukemia: a report from the Children's Oncology Group

“…Adult patients with t(8;21) AML have been reported to have higher complete remission rates after standard induction therapy and favorable outcomes, especially after dose-intensified ara-C (cytosine arabinoside)-based post-remission therapy (Bloomfield et al, 1998;Grimwade et al, 1998;Byrd et al, 1999;Schlenk et al, 2004). However, reports on children with t(8;21) AML have been mixed and include both favorable as well as standard prognoses (Grimwade et al, 1998;Chang et al, 2000;Rubnitz et al, 2002;Entz-Werle et al, 2005;Kardos et al, 2005;Perel et al, 2005;Smith et al, 2005). Recent studies using real-time reverse transcription (RT)-PCR quantitation of AML1-ETO (A1E) fusion transcripts in primary t(8;21) AML samples identified an association between high A1E transcript levels at diagnosis and shorter event-free survivals or overall survivals (Schnittger et al, 2003;Leroy et al, 2005;Yoo et al, 2005), suggesting that expression of A1E fusion proteins contribute to resistance to chemotherapy drugs such as ara-C.…”

‘Allogeneic marrow transplantation in children with acute leukemia: a practice whose time has gone’: twenty years later

“…An EORTC report by Entze-Werle et al 31 compared allo-HCT and continued chemo in children in first remission of AML after intensification therapy. Using donor availability for comparison the 7-year-estimated disease-free and overall survival, were Results reported from the AEIOP group by Pession et al 32 in their studies of children less than 16 years old with AML in first remission differ from those of the EORTC.…”