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Improved outcome after relapse in children with acute myeloid leukaemia

Abrahamsson, Jonas; Clausen, Niels; Gustafsson, Goran; Hovi, Liisa; Jonmundsson, Gudmundur; Zeller, Bernward; Forestier, Erik; Heldrup, Jesper LU and Hasle, Henrik (2007) In British Journal of Haematology 136(2). p.229-236
Abstract
In the Nordic Society for Paediatric Haematology and Oncology paediatric study acute myeloid leukaemia (AML) 93, event-free survival was 50% and overall survival was 66%, indicating that many patients were cured following relapse. Factors influencing outcome in children with relapsed AML were investigated. The study included all 146 children in the Nordic countries diagnosed with AML between 1988 and 2003, who relapsed. Data on disease characteristics and relapse treatment were related to outcome. Sixty-six percentage achieved remission with survival after relapse (5 years) 34 +/- 4%. Of 122 patients who received re-induction therapy, 77% entered remission with 40 +/- 5% survival. Remission rates were similar for different re-induction... (More)
In the Nordic Society for Paediatric Haematology and Oncology paediatric study acute myeloid leukaemia (AML) 93, event-free survival was 50% and overall survival was 66%, indicating that many patients were cured following relapse. Factors influencing outcome in children with relapsed AML were investigated. The study included all 146 children in the Nordic countries diagnosed with AML between 1988 and 2003, who relapsed. Data on disease characteristics and relapse treatment were related to outcome. Sixty-six percentage achieved remission with survival after relapse (5 years) 34 +/- 4%. Of 122 patients who received re-induction therapy, 77% entered remission with 40 +/- 5% survival. Remission rates were similar for different re-induction regimens but fludarabine, cytarabine, granulocyte colony-stimulating factor-based therapy had low treatment-related mortality. Prognostic factors for survival were duration of first complete remission (CR1) and stem cell transplantation (SCT) in CR1. In early relapse (< 1 year in CR1), survival was 21 +/- 5% compared with 48 +/- 6% in late relapse. For children receiving re-induction therapy, survival in early relapse was 29 +/- 6% and 51 +/- 6% in late. Patients treated in CR1 with SCT, autologous SCT or chemotherapy had a survival of 18 +/- 9, 5 +/- 5 and 41 +/- 5%, respectively. Survival was 62 +/- 6% in 64 children given SCT as part of their relapse therapy. A significant proportion of children with relapsed AML can be cured, even those with early relapse. Children who receive re-induction therapy, enter remission and proceed to SCT can achieve a cure rate of 60%. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
stem-cell transplantation, acute myeloid leukaemia, chemotherapy, relapse, children
in
British Journal of Haematology
volume
136
issue
2
pages
229 - 236
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • wos:000243298200006
  • scopus:33845874653
ISSN
0007-1048
DOI
10.1111/j.1365-2141.2006.06419.x
language
English
LU publication?
yes
id
f235ac40-37ee-4ce2-a8d9-6c1314e3dd16 (old id 679528)
date added to LUP
2007-12-11 09:06:44
date last changed
2017-11-05 03:40:00
@article{f235ac40-37ee-4ce2-a8d9-6c1314e3dd16,
  abstract     = {In the Nordic Society for Paediatric Haematology and Oncology paediatric study acute myeloid leukaemia (AML) 93, event-free survival was 50% and overall survival was 66%, indicating that many patients were cured following relapse. Factors influencing outcome in children with relapsed AML were investigated. The study included all 146 children in the Nordic countries diagnosed with AML between 1988 and 2003, who relapsed. Data on disease characteristics and relapse treatment were related to outcome. Sixty-six percentage achieved remission with survival after relapse (5 years) 34 +/- 4%. Of 122 patients who received re-induction therapy, 77% entered remission with 40 +/- 5% survival. Remission rates were similar for different re-induction regimens but fludarabine, cytarabine, granulocyte colony-stimulating factor-based therapy had low treatment-related mortality. Prognostic factors for survival were duration of first complete remission (CR1) and stem cell transplantation (SCT) in CR1. In early relapse (&lt; 1 year in CR1), survival was 21 +/- 5% compared with 48 +/- 6% in late relapse. For children receiving re-induction therapy, survival in early relapse was 29 +/- 6% and 51 +/- 6% in late. Patients treated in CR1 with SCT, autologous SCT or chemotherapy had a survival of 18 +/- 9, 5 +/- 5 and 41 +/- 5%, respectively. Survival was 62 +/- 6% in 64 children given SCT as part of their relapse therapy. A significant proportion of children with relapsed AML can be cured, even those with early relapse. Children who receive re-induction therapy, enter remission and proceed to SCT can achieve a cure rate of 60%.},
  author       = {Abrahamsson, Jonas and Clausen, Niels and Gustafsson, Goran and Hovi, Liisa and Jonmundsson, Gudmundur and Zeller, Bernward and Forestier, Erik and Heldrup, Jesper and Hasle, Henrik},
  issn         = {0007-1048},
  keyword      = {stem-cell transplantation,acute myeloid leukaemia,chemotherapy,relapse,children},
  language     = {eng},
  number       = {2},
  pages        = {229--236},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {British Journal of Haematology},
  title        = {Improved outcome after relapse in children with acute myeloid leukaemia},
  url          = {http://dx.doi.org/10.1111/j.1365-2141.2006.06419.x},
  volume       = {136},
  year         = {2007},
}