title: Fludarabine, treosulfan and etoposide sensitivity and the outcome of hematopoietic stem cell transplantation in childhood acute myeloid leukemia.
abstract: BACKGROUND
  The prognostic role of the ex vivo drug resistance profile has not yet been proved in childhood acute myeloid leukemia (AML). The aim of the study was the analysis of the impact of the ex vivo drug resistance profile in a cohort of 44 children with AML undergoing hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  Myeloblasts for drug resistance testing were obtained from the bone marrow either on diagnosis or at relapse, before the HSCT procedure and were tested by the MTT assay.
  
  
  RESULTS
  Children who relapsed after transplantation showed higher ex vivo resistance of the leukemic blasts to etoposide, mercaptopurine, thioguanine, fludarabine, mitoxantrone and treosulfan than those who stayed in remission. Despite being nondiscriminative, the combined ex vivo drug resistance profile to fludarabine, treosulfan and etoposide (FTE score) was the strongest prognostic factor by multivariate analysis.
  
  
  CONCLUSIONS
  The combined drug resistance profile to fludarabine, treosulfan and etoposide may be useful for better stratification of children with AML undergoing stem cell transplantation or to indicate the necessity for additional post-transplant therapy.
authors.affiliation: Department of Pediatric Hematology and Oncology, Medical College, Nicolaus Copernicus University, ul. Curie-Sklodowskiej 9, 85-094 Bydgoszcz, Poland. jstyczynski@cm.umk.pl
authors.forename: Jan
authors.initials: J
authors.lastname: Styczynski
authors.forename: Jacek
authors.initials: J
authors.lastname: Toporski
authors.forename: Mariusz
authors.initials: M
authors.lastname: Wysocki
authors.forename: Robert
authors.initials: R
authors.lastname: Debski
authors.forename: Alicja
authors.initials: A
authors.lastname: Chybicka
authors.forename: Dariusz
authors.initials: D
authors.lastname: Boruczkowski
authors.forename: Jacek
authors.initials: J
authors.lastname: Wachowiak
authors.forename: Beata
authors.initials: B
authors.lastname: Wojcik
authors.forename: Jerzy
authors.initials: J
authors.lastname: Kowalczyk
authors.forename: Lidia
authors.initials: L
authors.lastname: Gil
authors.forename: Walentyna
authors.initials: W
authors.lastname: Balwierz
authors.forename: Michal
authors.initials: M
authors.lastname: Matysiak
authors.forename: Maryna
authors.initials: M
authors.lastname: Krawczuk-Rybak
authors.forename: Anna
authors.initials: A
authors.lastname: Balcerska
authors.forename: Danuta
authors.initials: D
authors.lastname: Sonta-Jakimczyk
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000970:Antineoplastic Agents / Q000494:pharmacology*; D002066:Busulfan / Q000031:analogs & derivatives / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D019008:Drug Resistance, Neoplasm; D005047:Etoposide / Q000494:pharmacology; D005260:Female; D042381:Granulocyte Precursor Cells / Q000187:drug effects*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D007951:Leukemia, Myeloid / Q000601:surgery*; D008297:Male; D011379:Prognosis; D012008:Recurrence; D016896:Treatment Outcome; D014740:Vidarabine / Q000031:analogs & derivatives / Q000494:pharmacology
chemical_list: D000970:Antineoplastic Agents; D005047:Etoposide; C018404:treosulfan; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine