1. Advances in the First Line Treatment of Pediatric Acute Myeloid Leukemia in the Polish Pediatric Leukemia and Lymphoma Study Group from 1983 to 2019
- Author
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Karolina Bukowska-Strakova, Tomasz Urasiński, Lucyna Maciejka-Kemblowska, Tomasz Szczepański, Katarzyna Pawińska-Wąsikowska, Jolanta Skalska-Sadowska, Teofila Książek, Katarzyna Muszyńska-Rosłan, Szymon Skoczeń, Barbara Sikorska-Fic, Małgorzata Moj-Hackemer, Grażyna Karolczyk, Wanda Badowska, Michał Matysiak, Jerzy Kowalczyk, Wojciech Czogała, Natalia Bartoszewicz, Mariusz Wysocki, Katarzyna Mycko, Walentyna Balwierz, Krzysztof Kałwak, Agnieszka Mizia-Malarz, Małgorzata Czogała, Renata Tomaszewska, Dominik Grabowski, Agnieszka Chodala-Grzywacz, Małgorzata Ciebiera, Justyna Urbańska-Rakus, Radosław Chaber, Jacek Wachowiak, Ninela Irga-Jaworska, Katarzyna Bobeff, Karolina Zielezińska, Maryna Krawczuk-Rybak, and Wojciech Młynarski
- Subjects
Pediatric leukemia ,Cancer Research ,medicine.medical_specialty ,Down syndrome ,business.industry ,Treatment outcome ,Pediatric acute myeloid leukemia ,pediatric acute myeloid leukemia ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,survival ,Article ,Pediatric AML ,Lymphoma ,First line treatment ,Oncology ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Overall survival ,business ,neoplasms ,RC254-282 ,management - Abstract
Background: From 1983, standardized therapeutic protocols for pediatric acute myeloid leukemia (AML) based on the BFM group experience were introduced in Poland. We retrospectively analyzed the results of pediatric AML treatment in Poland from 1983 to 2019 (excluding promyelocytic, therapy-related, biphenotypic, and Down syndrome AML). Methods: The study included 899 children suffering from AML treated with the following: AML-PPPLBC 83 (1983–1993, n = 187), AML-PPGLBC 94 (1994–1997, n = 74), AML-PPGLBC 98 (1998–2004, n = 151), AML-BFM 2004 Interim (2004–2015, n = 356), and AML-BFM 2012 (2015–2019, n = 131). Results: The probability of three-year overall survival was 0.34 ± 0.03, 0.37 ± 0.05, 0.54 ± 0.04, 0.67 ± 0.03, and 0.75 ± 0.05, event-free survival was 0.31 ± 0.03, 0.34 ± 0.05, 0.44 ± 0.04, 0.53 ± 0.03, and 0.67 ± 0.05, and relapse-free survival was 0.52 ± 0.03, 0.65 ± 0.05, 0.58 ± 0.04, 0.66 ± 0.03, and 0.78 ± 0.05, respectively, in the subsequent periods. A systematic reduction of early deaths and deaths in remission was achieved, while the percentage of relapses decreased only in the last therapeutic period. Surprisingly good results were obtained in the group of patients treated with AML-BFM 2012 with unfavorable genetic abnormalities like KMT2A-MLLT10/t(10, 11)(p12, q23) and DEK-NUP214/t(6, 9)(p23, q24), while unsatisfactory outcomes were found in the patients with FLT3-ITD. Conclusions: The use of standardized, systematically modified therapeutic protocols, with the successive consideration of genetic prognostic factors, and advances in supportive care led to a significant improvement in AML treatment outcomes over the last 40 years.
- Published
- 2021