Characteristics and treatment results of refractory and relapsed acute myeloid leukaemia in paediatric patients treated in Polish Paediatric Leukaemia/Lymphoma Study Group institutions according to the Protocol Acute Myeloid Leukaemia BerlinFrankfurt-Munster 2012 and a review of novel treatment possibilities in paediatric acute myeloid leukaemia

被引：0

作者：

Samborska, Magdalena ^{[1
,18
]}

Skalska-Sadowska, Jolanta ^{[1
]}

Achkar, Robert ^{[2
]}

Wachowiak, Jacek ^{[1
]}

Derwich, Katarzyna ^{[1
]}

Czogala, Malgorzata ^{[3
]}

Balwierz, Walentyna ^{[3
]}

Skoczen, Szymon ^{[3
]}

Dobaczewski, Grzegorz ^{[4
]}

Chybicka, Alicja ^{[4
]}

Kalwak, Krzysztof ^{[4
]}

Krawczuk-Rybak, Maryna ^{[5
]}

Muszynska-Rostan, Katarzyna ^{[5
]}

Adamkiewicz-Droiynska, Elzbieta ^{[6
]}

Maciejka-Kapuscinska, Lucyna ^{[6
]}

Irga-Jaworska, Ninela ^{[6
]}

Pohorecka, Joanna ^{[7
]}

Chodata-Grzywacz, Agnieszka ^{[7
]}

Karolczyk, Graiyna ^{[7
]}

Wojcik, Beata ^{[7
]}

Kowalczyk, Jerzy R. ^{[8
]}

Drabko, Katarzyna ^{[8
]}

Zawitkowska, Joanna ^{[8
]}

Mycko, Katarzyna ^{[9
]}

Badowska, Wanda ^{[9
]}

Ociepa, Tomasz ^{[10
]}

Urasinski, Tomasz ^{[10
]}

Sikorska-Fic, Barbara ^{[11
]}

Matysiak, Michal ^{[11
]}

Laguna, Pawel ^{[11
]}

Dabrowska-Pawliszyn, Anna ^{[12
]}

Tomaszewska, Renata ^{[12
]}

Szczepanski, Tomasz ^{[12
]}

Sobol, Graiyna ^{[13
]}

Mizia-Malarz, Agnieszka ^{[13
]}

Ciebiera, Malgorzata ^{[14
]}

Chaber, Radoslaw ^{[14
]}

Koltan, Sylwia ^{[15
]}

Wysocki, Mariusz ^{[15
]}

Styczynski, Jan ^{[15
]}

Woszczyk, Mariola ^{[16
]}

Wieczorek, Maria ^{[16
]}

Karpinska-Derda, Irena ^{[16
]}

Urbanska-Rakus, Justyna ^{[16
]}

Bobeff, Katarzyna ^{[17
]}

Trelinska, Joanna ^{[17
]}

Mlynarski, Wojciech ^{[17
]}

机构：

[1] Univ Med Sci, Dept Pediat Hematol Oncol & TransplantolOncol & T, Poznan, Poland

[2] Univ Med Sci, Poznan, Poland

[3] Univ Children Hosp, Dept Pediat Oncol & Hematol, Krakow, Poland

[4] Wroclaw Med Univ, Clin Dept Pediat Bone Marrow Transplantat Oncol &, Wroclaw, Poland

[5] Med Univ, Dept Pediat Oncol & Hematol, Bialystok, Poland

[6] Med Univ, Dept Pediat Hematol & Oncol, Gdansk, Poland

[7] Reg Polyclin Hosp, Dept Pediat Hematol & Oncol, Kielce, Poland

[8] Med Univ, Dept Pediat Hematol Oncol & Transplantol, Lublin, Poland

[9] Prov Childrens Hosp, Dept Pediat & Hematol & Oncol, Olsztyn, Poland

[10] Pomeranian Med Univ, Dept Pediat HematoOncol & Gastroenterol, Szczecin, Poland

[11] Med Univ, Dept Oncol Pediat Hematol Transplantol & Pediat, Warsaw, Poland

[12] Silesian Univ Med, Dept Pediat Hematol & Oncol, Zabrze, Poland

[13] Med Univ Silesia, Katowice, Poland

[14] Clin Prov Hosp, Dept Pediat Oncohematol, Rzeszow, Poland

[15] Nicolaus Copernicus Univ Torun, Dept Pediat Hematol & Oncol, Coll Medicum, Bydgoszcz, Poland

[16] Pediat Ctr, Dept Pediat Hematol & Oncol, Chorzow, Poland

[17] Med Univ, Dept Pediat Oncol & Hematol, Lodz, Poland

[18] Uniwersytet Med Karola Marcinkowskiego, Klin Onkol Hematol & Transplantol Pediat, Poznan, Poland

来源：

WSPOLCZESNA ONKOLOGIA-CONTEMPORARY ONCOLOGY | 2023年 / 27卷 / 04期

关键词：

children; acute myeloid leukaemia; relapse; refractory; novel therapies; CHILDREN; RECOMMENDATIONS; CHEMOTHERAPY; CYTARABINE; MANAGEMENT; DIAGNOSIS;

D O I：

10.5114/wo.2023.135327

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: This study aimed to present the clinical features and results of treatment of patients diagnosed with refractory or relapsed acute myeloid leukaemia (AML) in Polish Paediatric Leukaemia/Lymphoma Study Group (PPL/LSG) institutions, treated in accordance with the Protocol Acute Myeloid Leukaemia Berlin -Frankfurt -Munster 2012, as their first -line therapy. Material and methods: The outcome data of 10 patients with refractory AML (median age 9.5 years) and 30 with relapsed AML (median age 12 years) were analysed retrospectively. Re -induction was usually based on idarubicin, fludarabine, and cytarabine along with allogeneic haematopoietic stem cell transplant (allo-HSCT) in 5 patients with refractory AML and 7 relapsed AML children. Results: 37.5% (3/8) of refractory AML patients achieved second complete remission second complete remission (CRII). One of ten patients (1/10; 10%) was alive and stayed in complete remission for 34 months after the allo-HSCT. The probability of 3 -year event -free survival (pEFS) in this group was 0.125 +/- 0.11. In the group of relapsed AML patients, the CRII was achieved in 9 patients (34%), and the probability of survival was: pEFS = 0.24 +/- 0.08; probability overall survival (pOS) = 0.34 +/- 0.09, with significantly better results achieved in patients who underwent allo-HSCT (pOS = 0.54 +/- 0.14 vs. 0.08 +/- 0.08, p < 0.0001). Conclusions: The prognosis of refractory AML and the first AML recurrence in children who were first -line treated in PPL/LSG centres according to Protocol Acute Myeloid Leukaemia Berlin -Frankfurt -Munster 2012 is poor. Failures of re -induction treatment particularly result from difficulties in achieving remission. Allogeneic HSCT improves prognosis in children with refractory and first recurrent AML, under the condition it is performed in complete remission. Novel therapeutic approaches are needed to increase the remission rate and improve the outcomes.

引用

页码：249 / 254

页数：6

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