Improvement in outcome for children with acute nonlymphocytic leukemia. A report from the Childrens Cancer Study Group.
The Childrens Cancer Study Group conducted four therapeutic studies on a total of 1006 children with acute nonlymphocytic leukemia from 1972 to 1983. This report describes the therapeutic strategies of these studies and examines trends in induction rates and long-term outcome over this period. The remission induction rate has changed from 58% in 1972 to 1975 to 80% for the period 1980 to 1983, and the induction mortality dropped from 20% to 6%. Four-year survival probabilities from time of diagnosis have almost doubled from 19% to 36%. Few deaths occurred more than 5 years after diagnosis: children surviving in first remission beyond 5 years had a 92% survival rate and an 86% relapse-free survival rate over the next 5 years. In contrast, median survival after a marrow relapse was less than 6 months and the 6-year survival probability was 4%. The leukocyte count was a significant prognostic factor, and although the mortality for infants was high initially, long-term survival was not decreased.
Buckley
J D
JD
University of Southern California School of Medicine, Los Angeles.
Chard
R L
RL
Baehner
R L
RL
Nesbit
M E
ME
Lampkin
B C
BC
Woods
W G
WG
Hammond
G D
GD
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001374:Azacitidine / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000401:mortality / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage; D011379:Prognosis; D012074:Remission Induction; D013866:Thioguanine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D003561:Cytarabine; D014750:Vincristine; D003520:Cyclophosphamide; D011239:Prednisolone; D013866:Thioguanine; D001374:Azacitidine; D003630:Daunorubicin