Publication details

Development of treatment and clinical results in childhood acute myeloid leukemia in the Czech Republic

Authors	ŠRÁMKOVÁ Lucie ŠTĚRBA Jaroslav HRSTKOVÁ Hana MIHÁL Vladimír BLAŽEK Bohumír TIMR Pavel ČERNÁ Zdena PROCHÁZKOVÁ Daniela HAK Jiří SEDLÁČEK Petr JANOTOVÁ Iveta VODIČKOVÁ Elena ZEMANOVÁ Zuzana JAROŠOVÁ Marie OLTOVÁ Alexandra ZDRÁHALOVÁ Kateřina HRUSAK Ondrej MEJSTRIKOVA Ester SCHWARZ Jiří ZUNA Jan TRKA Jan STARÝ Jan
Year of publication	2013
Type	Article in Periodical
Magazine / Source	Memo - Magazine of European Medical Oncology
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1007/s12254-012-0059-3
Field	Oncology and hematology
Keywords	Acute myeloid leukemia; Children; AMLBFMA93; AML-BFM 98; AML-BFM 2004; Czech Republic
Description	Purpose Treatment of childhood acute myeloid leukemia (AML) was unified in the year 1993 according to acute myeloid leukemia-Berlin–Frankfurt–Munster (AML-BFM) protocols in the Czech Republic. We evaluated data on clinical and therapeutic results in children with AML treated in three subsequent trials, comparing two periods, June 1993 to February 2004 (AML-BFM 93 and 98) vs. March 2004 to December 2009 (AML-BFM 2004 trial).Patients and methods Data of 182 eligible patients were analyzed, 125 in AML-BFM 93 and 98 trials, and 57 in AML-BFM 2004 trial enrolled prior to December 2009. Down syndrome patients were excluded from analysis. Results In studies AML-BFM 93 and 98, 79.2 % of 125 patients achieved complete remission (CR), 19 patients (15.2 %) suffered from early death, 7 (5.6 %) were nonresponders, 33 (33.3 %) relapsed, 12 (12.1 %) died in CR, and 2 patients (2.0 %) developed secondary malignancy. The estimated probability of event-free survival (pEFS) at 5 years was 41.6 %, the overall survival (OS) at 5 years was 46.4 %. In AML-BFM 2004 trial, 93 % of 57 patients attained CR, 3 patients (5.2 %) suffered from early death, 1 (1.8 %) was nonresponder, 16 (30.2 %) relapsed, 2 (3.8 %) died in CR, and 2 patients (3.5 %) developed secondary malignancy. The estimated pEFS at 5 years was 56.1 %, 5-years overall survival (5y-OS) was 73.7 %. Conclusion Gradual improvement of CR rate and OS together with decreasing incidence of toxic deaths in AML patients were achieved because of gain of experience with very intensive modern treatment centralized in a limited number of institutions.