Unification of Treatment of Childhood Acute Myeloid Leukemia in the CzechRepublic According to AML-BFM 93 Study Protocol

Overview

Background.
Acute myeloid leukemia (AML) in children is rare. Although more resistant to chemotherapy thanacute lymphoblastic leukemia, its responsiveness and survival rates have considerably improved during the last 15years by virtue of intensification of chemotherapy and due to the better supportive care. Relapses still remain themain cause of treatment failure. Management of children with AML was unified in the Czech Republic in 1993according to AML-BFM 93 Study protocol.Methods and Results. Treatment results were evaluated in 61 patients, of whom 45 (73.8%) achieved completeremission. Five-year event-free-survival (EFS) was found in 42.3%, and overall survival was 45.3%. Prognosis ofthe standard-risk patients was significantly better than in the high-risk group (EFS 62.5% vs. 29.7%, p=0.03). Themost important prognostic factor was the early treatment response. Compared to chemotherapy, allogeneic stem-celltransplantation did not significantly improve the outcome of high-risk patients.Conclusions. Treatment results of children with AML in the Czech Republic are comparable to those achieved byleading leukemia study groups in the world. The aim of the next study is to increase the complete-remission rate byreducing early deaths.

Key words:
Acute myeloid leukemia, children, chemotherapy, stem cell transplantation.