Long-term results of children with acute myeloid leukemia: A report of three consecutive Phase III trials by the Children's Cancer Group: CCG 251, CCG 213 and CCG 2891

被引:95
作者
Smith, FO
Alonzo, T
Gerbing, RB
Woods, WG
Arceci, R
机构
[1] Childrens Hosp, Med Ctr, Div Hematol Oncol, Cincinnati, OH 45229 USA
[2] Univ Cincinnati, Coll Med, Cincinnati, OH USA
[3] Univ So Calif, Dept Prevent Med, Keck Sch Med, Los Angeles, CA 90089 USA
[4] Childrens Oncol Grp, Arcadia, CA USA
[5] Emory Univ, Atlanta, GA 30322 USA
[6] Childrens Healthcare Atlanta, Atlanta, GA USA
[7] Johns Hopkins Univ, Kimmel Comprehens Canc Ctr Johns Hopkins, Baltimore, MD USA
关键词
pediatrics; acute myeloid leukemia; bone marrow transplantation;
D O I
10.1038/sj.leu.2403925
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The Children's Cancer Group (CCG) conducted three Phase III prospective clinical trials for children with de novo acute myeloid leukemia between the years 1979 and 1995. A total of 1903 eligible children ages birth to 21 years of age were enrolled on CCG 251 (n = 485), CCG 213 (n = 532) and CCG 2891 (n = 886). Follow-up is ongoing, with medians of 7.9, 10.9 and 8.6 years, respectively. These three clinical trials developed dose- and time-intensive induction regimens based upon high-dose cytarabine and daunomycin and randomly assigned patients to allogeneic bone marrow transplantation in first remission if an HLA-matched related donor was identified. Despite dose- and time-intensive induction regimens, remission induction rates remained relatively stable at 77 - 78%. However, overall survival, event-free survival and disease-free survival (DFS) increased for patients receiving intensive-timing induction therapy in comparison to patients who received standard-timing induction, regardless of the type of postremission therapy. Outcomes were best for patients receiving intensive-timing induction followed by matched related donor allogeneic transplantation with DFS of 65 +/- 9% at 6 years. These three clinical trials have established a strong foundation for the development of future studies focusing on further risk group stratification and the development of novel, molecularly-targeted therapies.
引用
收藏
页码:2054 / 2062
页数:9
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