title: [Treatment failure in children with acute myelocytic leukemia: over 25-year experience of Polish Pediatric Leukemia/Lymphoma Study Group with four consecutive unified treatment protocols for childhood acute myelocytic leukemia].
abstract: Four consecutive intensive unified regimens (BFM-AML-83, PGP-AML 94, PGP-AML 98 AML-BFM 2004 Interim) for acute myelocytic leukemia (AML) have been conducted by the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG) since 1983. The last one, introduced four years ago is still active, and only preliminary result may be presented. There were 726 children with AML diagnosed (226, 102, 247 and 151 in the I, II , III and IV periods, respectively), and 603 of them were eligible for evaluation (208, 83, 195 and 117, respectively). Complete remission rates were: 71.4%, 67.5%, 81.4% and 87% in consecutive periods, respectively. Five-year overall survival (OS) and event-free survival (EFS) rates were: 33% and 32% for PGP-AML 83 regimen, 38% and 36% for PGP-AML 94 regimen, and 53% and 46% for PGP-AML 98 regimen, respectively. For AML-BFM Interim 2004 the 3-year OS and EFS were 57% and 57%, respectively. Despite continuous improvement of the treatment results, the number of failures have remained too high, but the pattern have changed in the following way: Early deaths (from diagnosis to 15 day of treatment) decreased only in the fourth period to 3%. "Aplasia deaths" (between day 15 and 42) decreased gradually from 16% in the first period to 1.5% and 2.2% in the third and in the fourth period, respectively. Deaths in remission decreased from 10% in first and second period to 3.5% at present. Number of non responders increased between first and second period from 6% to 18%, later decreased to 8.2% at present. These trends e.g. decrease of early death and treatment related mortality reflect both the better efficacy of antileukemic treatment and the improvement of supportive care.
authors.affiliation: Klinika Onkologii i Hematologii Dzieciecej, PA Instytut Pediatrii UJ-CM, Kraków.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Dłuzniewska
authors.forename: Walentyna
authors.initials: W
authors.lastname: Balwierz
authors.forename: Anna
authors.initials: A
authors.lastname: Balcerska
authors.forename: Alicja
authors.initials: A
authors.lastname: Chybicka
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Kamieńska
authors.forename: Grazyna
authors.initials: G
authors.lastname: Karolczyk
authors.forename: Irena
authors.initials: I
authors.lastname: Karpińska-Derda
authors.forename: Maryna
authors.initials: M
authors.lastname: Krawczuk-Rybak
authors.forename: Jerzy R
authors.initials: JR
authors.lastname: Kowalczyk
authors.forename: Danuta
authors.initials: D
authors.lastname: Lewandowska
authors.forename: Lucyna
authors.initials: L
authors.lastname: Maciejka-Kapuścińska
authors.forename: Sylwia
authors.initials: S
authors.lastname: Kołtano
authors.forename: Iwona
authors.initials: I
authors.lastname: Malinowska
authors.forename: Michał
authors.initials: M
authors.lastname: Matysiak
authors.forename: Maria
authors.initials: M
authors.lastname: Mikołajczyk
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Mizia-Malarz
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Muszyńska-Rosłan
authors.forename: Marek
authors.initials: M
authors.lastname: Niedźwiedzki
authors.forename: Joanna
authors.initials: J
authors.lastname: Pohorecka
authors.forename: Barbara
authors.initials: B
authors.lastname: Sikorska-Fic
authors.forename: Grazyna
authors.initials: G
authors.lastname: Sobol
authors.forename: Danuta
authors.initials: D
authors.lastname: Sońta-Jakimczyk
authors.forename: Renata
authors.initials: R
authors.lastname: Tomaszewska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urasiński
authors.forename: Jacek
authors.initials: J
authors.lastname: Wachowiak
authors.forename: Maria
authors.initials: M
authors.lastname: Wieczorek
authors.forename: Beata
authors.initials: B
authors.lastname: Wójcik
authors.forename: Mariusz
authors.initials: M
authors.lastname: Wysocki
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011044:Poland / Q000453:epidemiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality; D012074:Remission Induction; D015996:Survival Rate; D017211:Treatment Failure