title: Experience with four consecutive BFM-based protocols for treatment of childhood with non-promyelocytic acute myeloblastic leukemia in Argentina.
abstract: Childhood acute myeloid leukemia (AML) achieves event-free-survival (EFS) rates of ∼50%. Double induction phase has been introduced for improving these results. Four consecutive protocols for AML treatment were evaluated to assess the impact of the addition of a second induction course in our setting. From January 1990 to January 2014, 307 evaluable AML patients were accrued. They were classified into low-risk (LR) and high-risk (HR) according to cytogenetic/molecular findings and response on day 15. The first two studies administered one induction cycle while the latter two protocols administered double induction. Relapse was the most frequent event and early-deaths were reduced by 50% in the last protocol. Statistically significant differences were observed when comparing EFS in LR and HR groups. Patients from both risk-groups who received double induction achieved significantly better outcome. EFS improved in protocols with double induction and early-deaths rate was decreased. Cytogenetic/molecular features and early-response were confirmed as prognostic factors.
authors.affiliation: a Hematology and Oncology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Maria S
authors.initials: MS
authors.lastname: Felice
authors.affiliation: b Immunology-Rheumatology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Rossi
authors.affiliation: a Hematology and Oncology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Cristina N
authors.initials: CN
authors.lastname: Alonso
authors.affiliation: c Genetics Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina.
authors.forename: Marta S
authors.initials: MS
authors.lastname: Gallego
authors.affiliation: a Hematology and Oncology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Silvia Eandi
authors.initials: SE
authors.lastname: Eberle
authors.affiliation: a Hematology and Oncology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Alfaro
authors.affiliation: a Hematology and Oncology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Myriam R
authors.initials: MR
authors.lastname: Guitter
authors.affiliation: b Immunology-Rheumatology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Bernasconi
authors.affiliation: a Hematology and Oncology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Rubio
authors.affiliation: c Genetics Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina.
authors.forename: Mariela C
authors.initials: MC
authors.lastname: Coccé
authors.affiliation: a Hematology and Oncology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Zubizarreta
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001118:Argentina; D001215:Asparaginase / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D060830:Consolidation Chemotherapy; D003630:Daunorubicin / Q000009:adverse effects / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011379:Prognosis; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D014750:Vincristine; D001215:Asparaginase; D011241:Prednisone; D003630:Daunorubicin
keywords: Acute myeloid leukemia; childhood; induction therapy; prognosis; risk groups