Second Relapse of Pediatric Patients with Acute Myeloid Leukemia: A Report on Current Treatment Strategies and Outcome of the AML-BFM Study Group

Autor: Nora Muehlegger, Ursula Creutzig, Emma Steidel, Jan Stary, Dirk Reinhardt, Lucie Sramkova, Christiane Walter, Naghmeh Niktoreh, Nils von Neuhoff, Heidrun Boztug, Thomas Lehrnbecher, Jean-Pierre Bourquin, Michael Dworzak, Iveta Janotova, Mareike Rasche, Martin Zimmermann, Edward A. Kolb
Přispěvatelé: University of Zurich, Rasche, Mareike
Rok vydání: 2021
Předmět:
Acute promyelocytic leukemia
Pediatrics
medicine.medical_specialty
Down syndrome
Immunology
Population
Medizin
childhood acute myeloid leukemia
610 Medicine & health
acute myeloid leukemia
Biochemistry
lcsh:RC254-282
Article
acute myeloid leukemia -- relapse -- childhood acute myeloid leukemia -- pediatric -- salvage therapy
Refractory
hemic and lymphatic diseases
medicine
Cumulative incidence
1306 Cancer Research
ddc:610
salvage therapy
education
relapse
education.field_of_study
business.industry
Medizinische Fakultät » Universitätsklinikum Essen » Zentrum für Kinder- und Jugendmedizin » Klinik für Kinderheilkunde III
Myeloid leukemia
Cell Biology
Hematology
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Clinical trial
Regimen
pediatric
10036 Medical Clinic
2730 Oncology
business
Zdroj: Cancers, Vol 13, Iss 789, p 789 (2021)
Cancers
Volume 13
Issue 4
ISSN: 2072-6694
Popis: Successful management of relapse is critical to improve outcomes of children with acute myeloid leukemia (AML). We evaluated response, survival and prognostic factors after a second relapse of AML. Among 1222 pediatric patients of the population-based AML-Berlin–Frankfurt–Munster (BFM) study group (2004 until 2017), 73 patients met the quality parameters for inclusion in this study. Central review of source documentation warranted the accuracy of reported data. Treatment approaches included palliation in 17 patients (23%), intensive therapy with curative intent (n = 46, 63%) and other regimens (n = 10). Twenty-five patients (35%) received hematopoietic stem cell transplantation (HSCT), 21 of whom (88%) had a prior HSCT. Survival was poor, with a five-year probability of overall survival (pOS) of 15 ± 4% and 31 ± 9% following HSCT (n = 25). Early second relapse (within one year after first relapse) was associated with dismal outcome (pOS 2 ± 2%, n = 44 vs. 33 ± 9%, n = 29
p <
0.0001). A third complete remission (CR) is required for survival: 31% (n = 14) of patients with intensive treatment achieved a third CR with a pOS of 36 ± 13%, while 28 patients (62%) were non-responders (pOS 7 ± 5%). In conclusion, survival is poor but possible, particularly after a late second relapse and an intensive chemotherapy followed by HSCT. This analysis provides a baseline for future treatment planning.
Databáze: OpenAIRE
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