title: Treatment of acute myeloid leukemia in children: experience from a tertiary care hematology centre in India.
abstract: OBJECTIVE
  To assess the treatment and outcome of children with acute myeloid leukemia. The Primary objectives were to assess remission rates, treatment related toxicity and disease free survival. Secondary objective was to assess prognostic factors associated with poor outcome.
  
  
  METHODS
  A retrospective analysis of all treated patients with acute myeloid leukemia, less than 18 year of age from Sept 2005 to Aug 2009 was done. Clinical laboratory, treatment and follow up records retrieved to calculate remission rate, treatment related toxicity, disease free survival and poor prognostic factors.
  
  
  RESULTS
  This analysis included thirty five patients (male : female; 23:12), twenty seven (77.1%) achieved remission after one 3 + 7 induction and seven required two inductions. High dose cytosine arabinoside consolidation was given in thirty one patients while one underwent allogenic stem cell transplantation. Two patients died during chemotherapy (TRM- 5.7%), two did not complete the therapy, seventeen relapsed (48.5%) with 80% of relapses occurring within first year of remission and no relapse occurred after 2 years. Fourteen patients are in remission (40%, follow up 5-54 months) and cumulative median disease free survival is of 13 months.
  
  
  CONCLUSIONS
  The present data suggests that 3 + 7 induction, followed by high dose cytarabine consolidation has low treatment related toxicity and resource utilization; however, relapse free survival is inferior to more intensive regimens, highlighting the need to intensify chemotherapy regimen once the treatment related mortality has been minimized.
authors.affiliation: Department of Hematology, All India Institute of Medical Sciences, Ist Floor, IRCH Builiding, Ansari Nagar, New Delhi 110029, India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Gupta
authors.forename: Tulika
authors.initials: T
authors.lastname: Seth
authors.forename: Pravas
authors.initials: P
authors.lastname: Mishra
authors.forename: Manoranjan
authors.initials: M
authors.lastname: Mahapatra
authors.forename: Shyam
authors.initials: S
authors.lastname: Rathi
authors.forename: Rajan
authors.initials: R
authors.lastname: Kapoor
authors.forename: Narendra
authors.initials: N
authors.lastname: Agarwal
authors.forename: Suman
authors.initials: S
authors.lastname: Kumar
authors.forename: Renu
authors.initials: R
authors.lastname: Saxena
mesh_terms: D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D033581:Stem Cell Transplantation
chemical_list: D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine