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Outcome of poor response paediatric AML using early SCT

Wareham, Neval E. ; Heilmann, Carsten ; Abrahamsson, Jonas ; Forestier, Erik ; Gustafsson, Britt ; Ha, Shau-Yin ; Heldrup, Jesper LU ; Jahnukainen, Kirsi ; Jonsson, Olafur G. and Lausen, Birgitte , et al. (2013) In European Journal of Haematology 90(3). p.187-194
Abstract
Background Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients treated with SCT. Material and Methods Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n=17) or > 5% blasts after AM (n=14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a... (More)
Background Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients treated with SCT. Material and Methods Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n=17) or > 5% blasts after AM (n=14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available. Results Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13, matched sibling donors in 6, cord blood donor in 4, and haploidentical donor in two. The median follow-up for the 31 poor responding patients was 2.6 years (range 0.4 - 8.1 years) and 3-year probability of survival 70% (95% CI 59-77%). Conclusions The poor responders in the NOPHO-AML 2004 protocol had a favourable prognosis treated with time-intensive induction followed by SCT. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute myeloid leukaemia, early stem cell transplantation, survival, poor, response
in
European Journal of Haematology
volume
90
issue
3
pages
187 - 194
publisher
Wiley-Blackwell
external identifiers
  • wos:000315111700002
  • scopus:84874001217
  • pmid:23215948
ISSN
1600-0609
DOI
10.1111/ejh.12051
language
English
LU publication?
yes
id
dc0d178f-4e61-465d-b122-fb68afdb5981 (old id 3576970)
date added to LUP
2016-04-01 09:48:41
date last changed
2022-04-11 23:06:02
@article{dc0d178f-4e61-465d-b122-fb68afdb5981,
  abstract     = {{Background Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients treated with SCT. Material and Methods Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n=17) or > 5% blasts after AM (n=14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available. Results Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13, matched sibling donors in 6, cord blood donor in 4, and haploidentical donor in two. The median follow-up for the 31 poor responding patients was 2.6 years (range 0.4 - 8.1 years) and 3-year probability of survival 70% (95% CI 59-77%). Conclusions The poor responders in the NOPHO-AML 2004 protocol had a favourable prognosis treated with time-intensive induction followed by SCT.}},
  author       = {{Wareham, Neval E. and Heilmann, Carsten and Abrahamsson, Jonas and Forestier, Erik and Gustafsson, Britt and Ha, Shau-Yin and Heldrup, Jesper and Jahnukainen, Kirsi and Jonsson, Olafur G. and Lausen, Birgitte and Palle, Josefine and Zeller, Bernward and Hasle, Henrik}},
  issn         = {{1600-0609}},
  keywords     = {{acute myeloid leukaemia; early stem cell transplantation; survival; poor; response}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{187--194}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{European Journal of Haematology}},
  title        = {{Outcome of poor response paediatric AML using early SCT}},
  url          = {{http://dx.doi.org/10.1111/ejh.12051}},
  doi          = {{10.1111/ejh.12051}},
  volume       = {{90}},
  year         = {{2013}},
}