[Consolidation of therapy of acute myeloid leukemia with the AML-BFM 93 protocol in children in the Czech Republic].
BACKGROUND
Acute myeloid leukemia (AML) in children is rare. Although more resistant to chemotherapy than acute lymphoblastic leukemia, its responsiveness and survival rates have considerably improved during the last 15 years by virtue of intensification of chemotherapy and due to the better supportive care. Relapses still remain the main cause of treatment failure. Management of children with AML was unified in the Czech Republic in 1993 according to AML-BFM 93 Study protocol.


RESULTS
Treatment results were evaluated in 61 patients, of whom 45 (73.8%) achieved complete remission. Five-year event-free-survival (EFS) was found in 42.3%, and overall survival was 45.3%. Prognosis of the standard-risk patients was significantly better than in the high-risk group (EFS 62.5% vs. 29.7%, p = 0.03). The most important prognostic factor was the early treatment response. Compared to chemotherapy, allogeneic stem-cell transplantation did not significantly improve the outcome of high-risk patients.


CONCLUSIONS
Treatment results of children with AML in the Czech Republic are comparable to those achieved by leading leukemia study groups in the world. The aim of the next study is to increase the complete-remission rate by reducing early deaths.
Starý
J
J
II. dĕtská klinika 2. LF UK a FNM, Praha. jan.stary@lfmotol.cuni.cz
Gajdos
P
P
Blazek
B
B
Ptoszková
H
H
Hrstková
H
H
Kopecná
L
L
Tousovská
K
K
Hak
J
J
Procházková
D
D
Cerná
Z
Z
Jabali
Y
Y
Timr
P
P
Vávra
V
V
Sedlácek
P
P
Smísek
P
P
Hrusák
O
O
Michalová
K
K
D000208:Acute Disease; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000627:therapeutic use*; D003630:Daunorubicin / Q000627:therapeutic use*; D005047:Etoposide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007951:Leukemia, Myeloid / Q000188:drug therapy*; D008297:Male
D003561:Cytarabine; D005047:Etoposide; D003630:Daunorubicin