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Development of treatment and clinical results in childhood acute myeloid leukemia in Slovenia in the period from 1991 to 2010

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Abstract

Background

A review of treatment and survival of children with acute myeloid leukemia (AML) in Slovenia from 1991 to 2010.

Methods

We collected demographic data, information on the time, and course of treatment of patients with AML, which were classified in three risk groups and treated according to standard arm of BFM AML protocols 83, 93, 98, and 04. We assessed the rate of remission, event-free survival and overall survival, the incidence of relapse, the secondary neoplasms, secondary AML, the proportion of patients treated with hematopoietic stem cell transplantation (HSCT) and causes of death. The 2- and 5-year overall survival (5yOS) was estimated according to age group, risk group, the presence of remission, and the time of the treatment.

Results

There were 50 patients, 18 males (36 %) and 32 females (64 %) included in this study. Secondary AML was presented in four patients. Patients treated with HSCT were 18 (36 %), 9 of them in first remission. The 2-year overall survival (2yOS) was 63.7 ± 6.8 % and 5-year survival was 55.0 ± 7.2 %. Differences in survival between age groups (0–5 years, 6–10 years and more than 10 years) was not significant. All patients in standard risk group lived for more than 2 years, in high-risk group 2yOS was 56.7 ± 7.7 % (p = 0.05). Patients who were in remission before second treatment block had 2yOS 77.8 ± 7.4 % and 5yOS 63.8 ± 8.8 %, compared to the patients who were not in remission (2yOSand 5yOS 37.5 ± 12.1 %, p = 0.001). The 2yOS in patients treated with HSCT in first remission was 62 %. There were 17 patients (34 %) who had relapse of the disease, 23 (64 %) patients died, 14 (61 %) due to progression of the disease.

Conclusions

The results of treatment of AML in our center are comparable with other European centers. Survival was better in the standard risk group and in patients who were in remission before second treatment block. We observed a trend of improvement in survival in the time observed.

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References

  1. Ching-Hong P. Childhood leukemias. Cambridge University Press; 2006.

  2. World health organization—Europe. Incidence of childhood leukemia. Fact sheet 4.1, December 2009, Code: RPG4_Rad_E1.

  3. Avcin S, Prelog T, Kavcic M, Kitanovski L, Anzic J, Benedik Dolnicar M, Rajic V, Zadravec Zaletel L, Debeljak M, Jazbec J. History of treatment and long-term outcome of childhood acute lymphoblastic leukemia in Slovenia. MEMO. 2011;4:178–83.

    Article  Google Scholar 

  4. Tsukimoto I, Tawa A, Horibe K, Tabuchi K, et al. Risk-stratified therapy and the intensive use of cytarabine improves the outcome in childhood acute myeloid leukemia: the AML99 Trial From the Japanese Childhood AML Cooperative Study Group. J Clin Oncol. 2009;27:4007–13.

    Article  PubMed  CAS  Google Scholar 

  5. Reinhardt D. Kooperative AML-BFM Therapiestudien [Internet]. Hannover: Medizinische Hochschule Hannover, Klinik und Poliklinik für Kinderheilkunde, Pädiatrische Hämatologie/ Onkologie; c 2005–2013 [cited 2013 May 7]. Available at: http://aml.mh-hannover.de/

  6. Woods WG. Curing childhood acute myeloid leukemia (AML) at the half-way point: promises to keep and miles to go before we sleep. Pediatr Blood Cancer. 46:565–9.

  7. Rubnitz J, Gibson B, Smith F. Acute myeloid leukemia. Hematol Oncol Clin North Am. 2010;24:35–63.

    Article  PubMed  Google Scholar 

  8. Smith M, Gloeckler Ries L, Gurney J, Ross J. Leukemia. SEER Pediatric Monograph, National Cancer Institute: 17–34.

  9. Razzouk BI, Estey E, Pounds S, Lensing S, Pierce S, Brandt M, et al. Impact of age on outcome of pediatric acute myeloid leukemia: a report from 2 institutions. Cancer. 2006;106(11):2495–502

    Article  PubMed  Google Scholar 

  10. Rubnitz JE, Lensing S, Zhou Y, Sandlund JT, Razzouk BI, Ribeiro RC, et al. Death during induction therapy and first remission of acute leukemia in childhood: the St. Jude experience. Cancer. 2004;101(7):1677–84.

    Article  PubMed  Google Scholar 

  11. Creutzig U, Büchner T, Sauerland MC, Zimmermann M, Reinhardt D, Döhner H, et al. Significance of age in acute myeloid leukemia patients younger than 30 years: a common analysis of the pediatric trials AML-BFM 93/98 and the adult trials AMLCG 92/99 and AMLSG HD93/98A. Cancer. 2008;112:562–71.

    Article  PubMed  Google Scholar 

  12. Schoch C, Kern W, Schnittger S, Büchner T, Hiddemann W, Torsten H. The influence of age on prognosis of de novo acute myeloid leukemia differs according to cytogenetic subgroups. Haematologica. 2004;89:1082–90.

    PubMed  Google Scholar 

  13. Horibe K, Tsukimoto I, Ohno R. Clinicopathologic characteristics of leukemia in Japanese children and young adults. Leukemia. 2001;15:1256–61.

    Article  PubMed  CAS  Google Scholar 

  14. Barnard DR, Lange B, Alonzo TA, Buckley J, Kobrinsky JN, Gold S, et al. Acute myeloid leukemia and myelodysplastic syndrome in children treated for cancer: comparison with primary presentation. Blood. 2002;100:427–34.

    Article  PubMed  CAS  Google Scholar 

  15. Ravindranath Y. Down syndrome and leukemia: new insights into the epidemiology, pathogenesis, and treatment. Pediatr Blood Cancer. 2005;44:1–7 (Commentary).

    Article  PubMed  Google Scholar 

  16. Hasle H, Niemeyer CM. Advances in the prognostication and management of advanced MDS in children. Br J Haematol. 2011;154:185–95.

    Article  PubMed  Google Scholar 

  17. Tilak V, Sookmane DD, Gupta V, Shukla J. Myelodysplastic syndrome. Indian J Pediatr. 2008;75(7):729–32.

    Article  PubMed  CAS  Google Scholar 

  18. Abrahamsson J, Forestier E, Heldrup J, Jahnukainen K, et al. Response-guided induction therapy in pediatric acute myeloid leukemia with excellent remission rate. J Clin Oncol. 2011;29:310–15.

    Article  PubMed  Google Scholar 

  19. Creutzig U, Zimmermann M, Ritter J, Reinhardt D, Hermann J, Henze G, et al. Treatment strategies and long-term results in paediatric patients treated in four consecutive AML-BFM trials. Leukemia. 2005;19:2030–42.

    Article  PubMed  CAS  Google Scholar 

  20. Creutzig U, Zimmermann M, Lehrnbecher T, Graf N, et al. Less toxicity by optimizing chemotherapy, but not by addition of granulocyte colony-stimulating factor in children and adolescents with acute myeloid leukemia: results of AML-BFM 98. J Clin Oncol. 2006;24:4499–506.

    Article  PubMed  CAS  Google Scholar 

  21. Kern W, Haferlach T, Schoch C, Löffler H, Gassmann W, Heinecke A, et al. Early blast clearance by remission induction therapy is a major independent prognostic factor for both achievement of complete remission and long-term outcome in acute myeloid leukemia: data from the German AML Cooperative Group (AMLCG) 1992 Trial.

  22. Niewerth D, Creutzig C, Bierings MB, Kaspers GJL. A review on allogeneic stem cell transplantation for newly diagnosed pediatric acute myeloid leukemia. Blood. 2010;116:2205–14.

    Article  PubMed  CAS  Google Scholar 

  23. Mlakar U. Treatment of acute myeloid leukemia in adults in the period 2008–2011 at the university medical centre Ljubljana. Zdr.Vest. 2012;Supp. II:21–6.

    Google Scholar 

  24. Harrison CJ, Hills RK, Moorman AV, et al. Cytogenetics of childhood acute myeloid leukemia: United Kingdom medical research council treatment trials AML 10 and 12. J Clin Oncol. 2010;28(16):2674–81.

    Article  PubMed  Google Scholar 

  25. Swerdlow SH, Campo E, Harris NL, et al. WHO Classification of tumors of hematopoietic and lymphoid tissues, 4th Edn. Geneva: WHO Press; 2008.

    Google Scholar 

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Conflict of interests

The authors Orjana Velikonja, Milica Stefanovic, Lidija Kitanovski, Helena Podgornik and Janez Jazbec declare that there is no conflict of interests.

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Authors and Affiliations

  1. Department of Paediatric Oncology and Haematology, University Medical Center, Bohoriceva 20, 1000, Ljubljana, Slovenia

    Orjana Velikonja MD, Milica Stefanović MD,  Lidija Kitanovski MSc, MD &  Janez Jazbec PhD, MD

  2. Specialized Haematology Laboratory, Haematology Department, University Medical Centre, Zaloska 7, 1000, Ljubljanja, Slovenia

    Helena Podgornik PhD

Authors
  1. Orjana Velikonja MD
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  2. Milica Stefanović MD
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  3. Lidija Kitanovski MSc, MD
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  4. Helena Podgornik PhD
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  5. Janez Jazbec PhD, MD
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Corresponding author

Correspondence to Orjana Velikonja MD.

Additional information

A part of the results of this article was prior presented at fourth Congress of Slovenian Haematologists in April 2012.

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Velikonja, O., Stefanović, M., Kitanovski, L. et al. Development of treatment and clinical results in childhood acute myeloid leukemia in Slovenia in the period from 1991 to 2010. memo 7, 56–62 (2014). https://doi.org/10.1007/s12254-013-0090-z

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  • DOI: https://doi.org/10.1007/s12254-013-0090-z

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