Acute myeloid leukaemia in childhood: the costs and benefits of intensive treatment

Summary. Response to treatment and resource implications were compared in two groups of children with acute myeloid leukaemia (AML) treated during consecutive periods. Event-free survival at 5 years improved from 12% (SE 3·4) during 1972–82 (group A) to 45% (SE 6·9) during 1983–87 (group B). The median time spent in hospital increased from 35 to 170 d. Allogeneic marrow transplantation was offered to all eligible children in group B. Eleven of the 53 children had a suitable donor and 10 proceeded to bone marrow transplantation (BMT). The relapse rate was lower after BMT than after chemotherapy, although not significantly so. We conclude that there has been a real improvement in prognosis for children with AML that modern treatment requires intensive hospital resources and that these results should encourage further efforts to improve outlook and to explore treatments not involving radiation.