Advances in the First Line Treatment of Pediatric Acute Myeloid Leukemia in the Polish Pediatric Leukemia and Lymphoma Study Group from 1983 to 2019

被引：11

作者：

Czogala, Malgorzata ^{[1
,2
]}

Balwierz, Walentyna ^{[1
,2
]}

Pawinska-Wasikowska, Katarzyna ^{[1
,2
]}

Ksiazek, Teofila ^{[3
]}

Bukowska-Strakova, Karolina ^{[4
]}

Czogala, Wojciech ^{[2
]}

Sikorska-Fic, Barbara ^{[5
]}

Matysiak, Michal ^{[5
]}

Skalska-Sadowska, Jolanta ^{[6
]}

Wachowiak, Jacek ^{[6
]}

Moj-Hackemer, Malgorzata ^{[7
]}

Kalwak, Krzysztof ^{[7
]}

Muszynska-Roslan, Katarzyna ^{[8
]}

Krawczuk-Rybak, Maryna ^{[8
]}

Grabowski, Dominik ^{[9
]}

Kowalczyk, Jerzy ^{[9
]}

Maciejka-Kemblowska, Lucyna ^{[10
]}

Irga-Jaworska, Ninela ^{[10
]}

Bobeff, Katarzyna ^{[11
]}

Mlynarski, Wojciech ^{[11
]}

Tomaszewska, Renata ^{[12
]}

Szczepanski, Tomasz ^{[12
]}

Chodala-Grzywacz, Agnieszka ^{[13
]}

Karolczyk, Grazyna ^{[13
]}

Mizia-Malarz, Agnieszka ^{[14
]}

Mycko, Katarzyna ^{[15
]}

Badowska, Wanda ^{[15
]}

Zielezinska, Karolina ^{[16
]}

Urasinski, Tomasz ^{[16
]}

Urbanska-Rakus, Justyna ^{[17
]}

Ciebiera, Malgorzata ^{[18
]}

Chaber, Radoslaw ^{[18
,19
]}

Bartoszewicz, Natalia ^{[20
]}

Wysocki, Mariusz ^{[20
]}

Skoczen, Szymon ^{[1
,2
]}

机构：

[1] Jagiellonian Univ Med Coll, Inst Pediat, Dept Pediat Oncol & Hematol, PL-31663 Krakow, Poland

[2] Univ Children Hosp, Dept Pediat Oncol & Hematol, PL-30663 Krakow, Poland

[3] Jagiellonian Univ Med Coll, Inst Pediat, Dept Med Genet, PL-31663 Krakow, Poland

[4] Jagiellonian Univ Med Coll, Inst Pediat, Dept Clin Immunol, PL-31663 Krakow, Poland

[5] Med Univ Warsaw, Dept Oncol Pediat Hematol Transplantol & Pediat, PL-02091 Warsaw, Poland

[6] Poznan Univ Med Sci, Dept Pediat Oncol Hematol & Transplantol, PL-60572 Poznan, Poland

[7] Wroclaw Med Univ, Dept Bone Marrow Transplantat Pediat Oncol & Hema, PL-50556 Wroclaw, Poland

[8] Med Univ Bialystok, Dept Pediat Oncol & Hematol, PL-15276 Bialystok, Poland

[9] Med Univ Lublin, Dept Pediat Hematol Oncol & Transplantol, PL-20090 Lublin, Poland

[10] Med Univ Gdansk, Dept Pediat Hematol & Oncol, PL-80211 Gdansk, Poland

[11] Med Univ Lodz, Dept Pediat Oncol & Hematol, PL-91738 Lodz, Poland

[12] Med Univ Silesia, Dept Pediat Hematol & Oncol, PL-41800 Zabrze, Poland

[13] Reg Polyclin Hosp Kielce, Dept Pediat Hematol & Oncol, PL-25736 Kielce, Poland

[14] Med Univ Silesia, Upper Silesia Childrens Care Hlth Ctr, Dept Oncol Hematol & Chemotherapy, PL-40752 Katowice, Poland

[15] Prov Childrens Hosp, Dept Pediat & Hematol & Oncol, PL-10561 Olsztyn, Poland

[16] Pomeranian Med Univ, Dept Pediat Hematol & Oncol, PL-71252 Szczecin, Poland

[17] City Hosp, Dept Pediat Hematol & Oncol, PL-41500 Chorzow, Poland

[18] Clin Prov Hosp Rzeszow, Dept Pediat Oncohematol, PL-35301 Rzeszow, Poland

[19] Univ Rzeszow, Med Coll, Inst Med Sci, Dept Pediat, PL-35310 Rzeszow, Poland

[20] Nicolaus Copernicus Univ Torun, Dept Paediat Haematol & Oncol, Coll Med Bydgoszcz, 85-094 Bydgoszcz, PL-85094 Bydgoszcz, Poland

来源：

CANCERS | 2021年 / 13卷 / 18期

关键词：

pediatric acute myeloid leukemia; survival; management; HIGH-DOSE CYTARABINE; CHILDREN; AML; INDUCTION; THERAPY; T(6/9)(P23; Q34); INTENSIFICATION; MITOXANTRONE; MIDOSTAURIN; IDARUBICIN;

D O I：

10.3390/cancers13184536

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary We retrospectively analyzed the results of the five consecutive treatment protocols for pediatric acute myeloid leukemia (AML) used in Poland from 1983 to 2019 (excluding promyelocytic, secondary, biphenotypic, and Down syndrome AML). The study included 899 children. The probability of three-year overall, event-free, and relapse-free survival increased from 0.34 +/- 0.03 to 0.75 +/- 0.05, 0.31 +/- 0.03 to 0.67 +/- 0.05, and 0.52 +/- 0.03 to 0.78 +/- 0.05, respectively. A systematic reduction of early deaths and deaths in remission was achieved, while the percentage of relapses decreased only in the last therapeutic period. Surprisingly good results were obtained in the group of patients with unfavorable genetic abnormalities like KMT2A-MLLT10/t(10;11)(p12;q23) and DEK-NUP214/t(6;9)(p23;q24) who were treated in the AML-BFM 2012 Registry, while an unsatisfactory outcome was found in patients with FLT3-ITD. The use of standardized therapeutic protocols with the successive consideration of genetic prognostic factors and advances in supportive care led to a significant improvement in AML treatment outcomes over the last 40 years. Background: From 1983, standardized therapeutic protocols for pediatric acute myeloid leukemia (AML) based on the BFM group experience were introduced in Poland. We retrospectively analyzed the results of pediatric AML treatment in Poland from 1983 to 2019 (excluding promyelocytic, therapy-related, biphenotypic, and Down syndrome AML). Methods: The study included 899 children suffering from AML treated with the following: AML-PPPLBC 83 (1983-1993, n = 187), AML-PPGLBC 94 (1994-1997, n = 74), AML-PPGLBC 98 (1998-2004, n = 151), AML-BFM 2004 Interim (2004-2015, n = 356), and AML-BFM 2012 (2015-2019, n = 131). Results: The probability of three-year overall survival was 0.34 +/- 0.03, 0.37 +/- 0.05, 0.54 +/- 0.04, 0.67 +/- 0.03, and 0.75 +/- 0.05; event-free survival was 0.31 +/- 0.03, 0.34 +/- 0.05, 0.44 +/- 0.04, 0.53 +/- 0.03, and 0.67 +/- 0.05; and relapse-free survival was 0.52 +/- 0.03, 0.65 +/- 0.05, 0.58 +/- 0.04, 0.66 +/- 0.03, and 0.78 +/- 0.05, respectively, in the subsequent periods. A systematic reduction of early deaths and deaths in remission was achieved, while the percentage of relapses decreased only in the last therapeutic period. Surprisingly good results were obtained in the group of patients treated with AML-BFM 2012 with unfavorable genetic abnormalities like KMT2A-MLLT10/t(10;11)(p12;q23) and DEK-NUP214/t(6;9)(p23;q24), while unsatisfactory outcomes were found in the patients with FLT3-ITD. Conclusions: The use of standardized, systematically modified therapeutic protocols, with the successive consideration of genetic prognostic factors, and advances in supportive care led to a significant improvement in AML treatment outcomes over the last 40 years.

引用

页数：18

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