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Outcome after intensive reinduction therapy and allogeneic stem cell transplant in paediatric relapsed acute myeloid leukaemia
Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Paediat, Gothenburg, Sweden..
Umea Univ, Dept Clin Sci, Paediat, Umea, Sweden..
Aarhus Univ, Hosp Skejby, Dept Paediat, Aarhus, Denmark..
Childrens Hosp, Div Haematol Oncol & Stem Cell Transplantat, Helsinki, Finland..
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2017 (English)In: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 178, no 4, 592-602 p.Article in journal (Refereed) Published
Abstract [en]

Given that 30-40% of children with acute myeloid leukaemia (AML) relapse after primary therapy it is important to define prognostic factors and identify optimal therapy. From 1993 to 2012, 543 children from the Nordic countries were treated according to two consecutive protocols: 208 children relapsed. The influence of disease characteristics, first line treatment, relapse therapy and duration of first remission on outcome was analysed. Second complete remission (CR2) was achieved in 146 (70%) patients. Estimated 5-year overall survival (OS5y) was 39 +/- 4% for the whole group and 43 +/- 4% for the 190 patients given re-induction therapy, of whom 76% received regimens that included fludarabine, cytarabine (FLA) +/- anthracyclines, 18% received Nordic Society for Paediatric Haematology and Oncology (NOPHO) upfront blocks and 5% received other regimens. Late relapse >= 1 year from diagnosis, no allogeneic stem cell transplantation (SCT) in first remission and core binding factor AML were independent favourable prognostic factors for survival. For the 128 children (124 in CR2) that received SCT as consolidation therapy after relapse, OS5y was 61 +/- 5%. Four of 19 children (21%) survived without receiving SCT as part of relapse therapy. Our data show that intensive re-induction followed by SCT can give cure rates of 40% in children with relapsed AML.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 178, no 4, 592-602 p.
Keyword [en]
acute myeloid leukaemia, relapsed, childhood, allogenic stem cell transplant, survival
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-333704DOI: 10.1111/bjh.14720ISI: 000406911500013PubMedID: 28439893OAI: oai:DiVA.org:uu-333704DiVA: diva2:1158721
Funder
Swedish Childhood Cancer FoundationRegion Västra Götaland
Available from: 2017-11-21 Created: 2017-11-21 Last updated: 2017-11-21Bibliographically approved

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