Treatment strategy and long-term results in pediatric patients treated in two consecutive AML-GATLA trials

Armendariz, H.; Barbieri, M A Fernandez; Freigeiro, D; Lastiri, Francisco; Felice, Marı́a Sara; Dibar, E

doi:10.1038/sj.leu.2403854

Cited by 14 publications

(8 citation statements)

References 7 publications

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“…Nevertheless it is similar to that reported by the Dutch group [26][27][28]. It is lower than the 26 to 36% reported by other Latin-American groups, but our study is not multicentre like theirs [29,30] Improvement of our strategies of prophylaxis and therapy for neutropenic patients should be explored in future trials.…”

Section: Discussioncontrasting

confidence: 44%

Improved treatment results in Mexican children with acute myeloid leukemia using a Medical Research Council (MRC)-acute myeloid leukemia 10 modified protocol

Gallegos-Castorena

Medina-Sansón

González-Ramella

et al. 2009

Leukemia & Lymphoma

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We analysed the results of three protocols from 1990 to 2005. Protocol I (1990-1996) consisted of a 2 year VAPA regime. Protocol II (1996-2003) on 1 year daunorubicin/cytarabine alternating with etoposide/cytarabine. Protocol III (2003-2005) on six cycles MRC AML 10 modified. Patients with de novo acute myeloid leukemia 0 to 18 years were included. Demographic and clinical characteristics were analysed. Patients with >100,000 leukocytes, M4 or M5 and primary CNS disease were considered high risk. We compared remission rate, overall and event-free survival. Descriptive statistics, chi square, Kaplan-Meier and long rank tests were used. One hundred forty-five patients were included, 46 in Protocol I; 60 in II and 39 in III. There were no differences in characteristics between groups, except for more low risk patients in Protocol II (61%vs. 43% and 41%. (p = 0.05). Remission rate for Protocol I was 52%, for II 50% and for III 92% (p = 0.0001). Relapse was 18, 30 and 35, respectively (p = 0.141). Five-year event-free survival was 17.9% +/- 6.6%, 15.5% +/- 4.1% and 43.5% +/- 4.1% (s.e) (p = 0.0002). Five-year overall survival was 19.5% +/- 8%, 17.2% +/- 5.9% and 51.2% +/- 4.1% (s.e) (p = 0.0002). The results were superior in the MRC-10 derived protocol.

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Section: Discussioncontrasting

confidence: 44%

Improved treatment results in Mexican children with acute myeloid leukemia using a Medical Research Council (MRC)-acute myeloid leukemia 10 modified protocol

Gallegos-Castorena

Medina-Sansón

González-Ramella

et al. 2009

Leukemia & Lymphoma

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…[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 …”

Section: Discussionmentioning

confidence: 99%

Improved treatment results for childhood acute myeloid leukemia in Taiwan

et al. 2005

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To improve treatment results for children with de novo acute myeloid leukemia (AML), we introduced a novel protocol, Taiwan Pediatric Oncology Group-AML-97A, for AML other than acute promyelocytic leukemia (APL), for which modified conventional protocols were used. From January 1, 1997, to December 31, 2002, 141 children younger than 17 years old with de novo AML were enrolled. In total, 117 patients with non-APL AML were treated with induction therapy of idarubicin and cytarabine (Ara-C), postremission therapy with high-dose Ara-C -containing regimens for four monthly courses, and moderatedose therapy with idarubicin and Ara-C for four monthly courses. The first 19 patients with APL were treated with alltrans retinoic acid, idarubicin and Ara-C, with the remaining five patients receiving all-trans retinoic acid and idarubicin, followed by maintenance therapy for 2 years. Stem cell transplantation was performed in 29 patients in first remission with a similar outcome as chemotherapy alone. The remission rate in the AML-97A study was 90%, the 5-year survival 5175.3% (s.e.) and the 5-year event-free survival 5074.8%; for APL, these were 100%, 8677.0, and 7579.8%. For the whole group, the 5-year survival was 5774.7% and the 5-year event-free survival 5474.4%. The AML-97A regimen was well tolerated.

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“…Cancer treatment in Argentina is granted free of cost to all children; however, because of significant socio-economic disparities and transport-related limitations, access to cancer care is still unequal, especially in the early phases of diagnosis. Treatment strategies for acute leukaemia are quite uniform across the country, with many of the patients enrolled in clinical trials [20,21]. Few studies have analysed paediatric cancer survival in Argentina.…”

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confidence: 99%