Improved Outcome of Children with Acute Myeloid Leukemia (AML) Treated with the Chemotherapy Protocol MRC AML10 at a North American Center - Central Role of Intensive Supportive Care. Session Type: Poster Session 448-II

Prabodh Das, William Chu, Johann Hitzler, Lillian Sung, John Doyle, Ronald Grant

Author address: 

Division of Hematology Oncology, Department of Pediatrics, The Hospital for Sick Children; Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada

Abstract: 

With chemotherapy protocols, such as UK MRC AML 10, approximately 45-50% of children with AML are expected to be cured. We analyzed the outcome of 20 children consecutively treated with this intensive multi-agent protocol at our institution between February 2000 and December 2002. Two courses of induction therapy with daunorubicin, cytarabine and thioguanine (DAT) were followed by two courses of consolidation therapy with amsacrine, cytarabine, etoposide (MACE) and mitoxantrone, cytarabine (MidAC), respectively. Each treatment course started upon recovery of neutrophil and platelet counts to greater than 1000/l and 100,000/l, respectively.Patients were discharged from the hospital when clinically stable. The age of the children, 11 male and 9 female, ranged from 1 to 16.8 years (median 8.1) . Four patients (20%) had CNS involvement. All patients achieved a complete remission , 85% after the first and 95% after the second course of induction therapy, respectively. There were no deaths during induction therapy. Of 17 children treated with chemotherapy alone, 12 ( 70% ) are in continuous complete remission (CCR) at a median follow up of 1.2 years (range 0.8-2.2 ).To date 4 ( 23% ) children have relapsed (one died of disease, one of invasive mucormycosis after relapse therapy; 2 are alive, one post matched unrelated bone marrow transplantation (BMT) and while one is awaiting for the same ). One patient died in remission of systemic aspergillosis 6 weeks after the last course of chemotherapy. Three of 20 patients (15%) underwent BMT in first remission either from a matched sibling donor (1 patient) or a matched unrelated donor ( 2 patients). Two of the transplanted patients remain in CCR after a follow up of 3.1 and 3.5 years, one patient died of recurrent disease. Thus, the projected 2-year event-free and overall survival of the entire cohort are 0.64 +/-0.3 (SEM) and 0.68 +/-0.16, respectively. The median duration of severe neutropenia (ANC
2003

abstract No: 

2277

Full conference title: 

American Society of Hematology 45th Annual Meeting
    • ASH 45th (2003)