ADE as Induction Therapy Results in Treatment of Children with Non-M3 High-Risk Acute Myeloid Leukemia, an Extrapolable Achievement in Developing Countries

Background: In Mexico, AML survival is referred in 30%. Our aim was to evaluate results with ADE protocol as induction treatment in children with non-M3 AML in a public Mexican institution. Method: We included patients with AML in a single institution between 2005 and 2013. All non-M3-AML patients received ADE as induction therapy (cytarabine 100 mg/m2 in continuous infusion from day 1 to 7, daunorrubicin 30 mg/m2 days 1, 3, 5 and etoposide 100 mg/m2 over days 1 to 5). Patients received antibiotic prophylaxis and strict scheduled appointments to assure adherence and prevent avoidable emergencies. Main Results: Eighteen patients were included. Median age was 106 months. One patient died at diagnosis so 17 were eligible for induction results analysis; eleven needed two cycles and six patients three. Remission rate was 100%. Analyzing non-M3 patients overall survival was 80.2% at 100 months. No fatal complications were observed. Stratifying by number of cycles we observe that patients receiving one ADE cycle had a 0% overall survival at short follow up, with 2 ADE cycles 80% at 100 months and with 3 cycles 100% at 60 months. Conclusion: ADE induction therapy showed improved results in overall survival compared with other standard regimens. Following the protocol we obtained 100% remission. This is an important achievement in our population. Our focus must be to ameliorate maintenance final results. These results should be reproduced in other hospitals in Mexico and other countries.