title: Development of treatment and clinical results in childhood acute myeloid leukemia in Poland.
abstract: Since 1983 four consecutive unified regimens: acute myeloid leukemia-Polish pediatric leukemia/lymphoma study group (AML-PPLLSG) 83, AML-PPLLSG 94, AML-PPLLSG 98 and AML-BFM 2004 Interim, for AML have been conducted by the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG). In this paper, we review four successive studies on the basis of acute myeloid leukemia-Berlin-Frankfurt-Munster (AML-BFM) protocol, in which a stepwise improvement of treatment outcome was observed. Treatment results of the last protocol AML-BFM 2004 Interim are presented in detail.
  
  
  
  Three hundred and three patients withde novoAML were treated according to the AML-BFM 2004 Interim at 15 Polish centers from January 1, 2005 to June 30, 2011. A confrontation with previous treatment periods was based upon historical, already published data.
  
  
  
  In four consecutive periods, 723 children were eligible for evaluation (208, 83, 195, and 237, respectively). Complete remission rates in consecutive periods were: 71, 68, 81 and 87 %, respectively. The 5-year overall survival rates, event-free survival rates, and relapse-free survival rates were 33, 32, and 45%, respectively for AML-PPLLSG 83 regimen; 38, 36, and 53 % respectively for AML-PPLLSG 94 regimen; 53, 46, and 65 % respectively for AML-PPLLSG 98 regimen, and 63, 52, and 64 % for AML-BFM Interim 2004, respectively. Incidence of early deaths and that due to complications (mainly infections) in the first remission decreased over time from 22 to 4.6 % and from 10 to 5.9 %, respectively.
  
  
  
  Despite continuous improvement in the treatment outcome, the number of failures still remains too high. Further progress seemed to be possible due to continued cooperation of oncology centers within large international study groups.
authors.affiliation: Pediatric, Oncology and Hematology Department, PA Institute of Pediatrics, Jagiellonian University Medical College, ul. Wielicka 265, 30-663 Krakow, Poland.
authors.forename: Walentyna
authors.initials: W
authors.lastname: Balwierz
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Pawinska-Wasikowska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Klekawka
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Czogala
authors.forename: Michal
authors.initials: M
authors.lastname: Matysiak
authors.forename: Barbara
authors.initials: B
authors.lastname: Fic-Sikorska
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Adamkiewicz-Drozynska
authors.forename: Lucyna
authors.initials: L
authors.lastname: Maciejka-Kapuscinska
authors.forename: Alicja
authors.initials: A
authors.lastname: Chybicka
authors.forename: Kinga
authors.initials: K
authors.lastname: Potocka
authors.forename: Jacek
authors.initials: J
authors.lastname: Wachowiak
authors.forename: Jolanta
authors.initials: J
authors.lastname: Skalska-Sadowska
authors.forename: Jerzy
authors.initials: J
authors.lastname: Kowalczyk
authors.forename: Beata
authors.initials: B
authors.lastname: Wojcik
authors.forename: Mariusz
authors.initials: M
authors.lastname: Wysocki
authors.forename: Sylwia
authors.initials: S
authors.lastname: Koltan
authors.forename: Maryna
authors.initials: M
authors.lastname: Krawczuk-Rybak
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Muszynska-Roslan
authors.forename: Wojciech
authors.initials: W
authors.lastname: Mlynarski
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Stolarska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Urasinski
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Kamienska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Szczepanski
authors.forename: Renata
authors.initials: R
authors.lastname: Tomaszewska
authors.forename: Grazyna
authors.initials: G
authors.lastname: Sobol
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Mizia-Malarz
authors.forename: Grazyna
authors.initials: G
authors.lastname: Karolczyk
authors.forename: Joanna
authors.initials: J
authors.lastname: Podhorecka
authors.forename: Maria
authors.initials: M
authors.lastname: Wieczorek
authors.forename: Irena
authors.initials: I
authors.lastname: Karpinska-Derda
authors.forename: Wanda
authors.initials: W
authors.lastname: Badowska
authors.forename: Angelina
authors.initials: A
authors.lastname: Moryl-Bujakowska
keywords: Acute myeloid leukemia; Children; Treatment results
references.citation: Blood. 2011 Nov 17;118(20):5409-15
references.pmid: 21948298
references.citation: Pediatr Blood Cancer. 2012 Nov;59(5):919-21
references.pmid: 22619004
references.citation: Haematologica. 2007 Nov;92(11):1519-32
references.pmid: 18024401
references.citation: Pol Tyg Lek. 1988 Mar 14;43(11):376-9
references.pmid: 3166136
references.citation: Leukemia. 2010 Aug;24(8):1422-8
references.pmid: 20535146
references.citation: Br J Haematol. 2011 Nov;155(3):366-76
references.pmid: 21902686
references.citation: Lancet Oncol. 2010 Jun;11(6):543-52
references.pmid: 20451454
references.citation: Haematologica. 2012 Jan;97(1):21-9
references.pmid: 21933851
references.citation: Cancer. 2008 Feb 1;112(3):562-71
references.pmid: 18076087
references.citation: Med Wieku Rozwoj. 2000;4(1 Suppl 2):33-41
references.pmid: 12021460
references.citation: J Clin Oncol. 2011 Jan 20;29(3):310-5
references.pmid: 21149663
references.citation: Cancer. 2012 Dec 15;118(24):6253-9
references.pmid: 22674050
references.citation: Leukemia. 2005 Dec;19(12):2117-24
references.pmid: 16107894
references.citation: Leukemia. 1996 Mar;10(3):389-95
references.pmid: 8642852
references.citation: J Clin Oncol. 2004 Nov 1;22(21):4384-93
references.pmid: 15514380
references.citation: Przegl Lek. 2010;67(6):366-70
references.pmid: 21344763
references.citation: Przegl Lek. 2010;67(6):371-4
references.pmid: 21344764
references.citation: Blood. 2010 Sep 30;116(13):2205-14
references.pmid: 20538803
references.citation: Blood. 2011 Jun 30;117(26):7102-11
references.pmid: 21551233
references.citation: Blood. 1990 May 15;75(10):1932-40
references.pmid: 2186819
references.citation: Pediatr Blood Cancer. 2011 Sep;57(3):398-405
references.pmid: 21681921
references.citation: Pediatr Blood Cancer. 2011 Dec 15;57(7):1222-9
references.pmid: 22095929
references.citation: Bone Marrow Transplant. 2008 Oct;42 Suppl 2:S7-9
references.pmid: 18978749
references.citation: Biol Blood Marrow Transplant. 2012 Jun;18(6):861-73
references.pmid: 22040843
references.citation: J Pediatr Hematol Oncol. 1995 Aug;17(3):225-33
references.pmid: 7620921
references.citation: Pediatr Blood Cancer. 2010 Sep;55(3):421-9
references.pmid: 20658611
references.citation: Pediatr Blood Cancer. 2010 Jul 15;55(1):157-64
references.pmid: 20232426
references.citation: Leukemia. 2001 Mar;15(3):348-54
references.pmid: 11237056
references.citation: J Clin Oncol. 2008 Dec 10;26(35):5797-801
references.pmid: 18955460