title: Continuous and high-dose cytarabine combined chemotherapy in children with down syndrome and acute myeloid leukemia: Report from the Japanese children's cancer and leukemia study group (JCCLSG) AML 9805 down study.
abstract: BACKGROUND
  The aim of the JCCLSG AML 9805 Down study was to evaluate the effect of continuous and high-dose cytarabine combined chemotherapy on the survival outcome of acute myeloid leukemia (AML) with Down syndrome (DS).
  
  
  METHODS
  From May 1998 to December 2006, DS patients with newly diagnosed AML were enrolled. Remission induction therapy consisted of two courses of pirarubicin, vincristine, and continuous-dose cytarabine (AVC1). The patients who achieved complete remission (CR) after two courses of AVC1 were subsequently treated with mitoxantrone and continuous-dose cytarabine (MC), etoposide and high-dose cytarabine (EC) and pirarubicin, vincristine, and continuous-dose cytarabine (AVC2).
  
  
  RESULTS
  Twenty-four patients were enrolled. All patients were younger than 4 years and diagnosed as having acute megakaryoblastic leukemia. Twenty-one patients achieved CR. Three patients died during remission induction therapy due to serious infection. No toxic deaths were observed during remission. All but one patient maintained CR without serious complications. The 5-year overall and event-free survivals were 87.5%  ± 6.8% and 83.1%  ± 7.7%, respectively.
  
  
  CONCLUSIONS
  Continuous and high-dose cytarabine combined chemotherapy with reduced intensity would be effective in DS children with AML.
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Japan. ttaga@belle.shiga-med.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Taga
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Shimomura
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Horikoshi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ogawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Itoh
authors.forename: Masahiko
authors.initials: M
authors.lastname: Okada
authors.forename: Junichi
authors.initials: J
authors.lastname: Ueyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Higa
authors.forename: Arata
authors.initials: A
authors.lastname: Watanabe
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kanegane
authors.forename: Asayuki
authors.initials: A
authors.lastname: Iwai
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saiwakawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kogawa
authors.forename: Junko
authors.initials: J
authors.lastname: Yamanaka
authors.forename: Masahito
authors.initials: M
authors.lastname: Tsurusawa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002675:Child, Preschool; D003561:Cytarabine / Q000008:administration & dosage*; D018572:Disease-Free Survival; D004314:Down Syndrome / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008942:Mitoxantrone / Q000008:administration & dosage; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D014750:Vincristine; D004317:Doxorubicin; D008942:Mitoxantrone; C027260:pirarubicin