Outcome of poor response paediatric AML using early SCT
Neval E. Wareham
Department of Paediatrics, The University Hospital Rigshospitalet, Copenhagen, Denmark
Search for more papers by this authorCarsten Heilmann
Department of Paediatrics, The University Hospital Rigshospitalet, Copenhagen, Denmark
Search for more papers by this authorJonas Abrahamsson
Department of Paediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
Search for more papers by this authorErik Forestier
Department of Medical Biosciences, Clinical Genetics, University of Umeå, Umeå, Sweden
Paediatric Haematology and Oncology, University Hospital of Umeå, Umeå, Sweden
Search for more papers by this authorBritt Gustafsson
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
Search for more papers by this authorShau-Yin Ha
Department of Paediatrics, Queen Mary Hospital and Hong Kong Paediatric Haematology & Oncology Study Group (HKPHOSG), Hong Kong, China
Search for more papers by this authorJesper Heldrup
Department of Paediatrics, University Hospital Lund, Lund, Sweden
Search for more papers by this authorKirsi Jahnukainen
Division of Haematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
Search for more papers by this authorÓlafur G. Jónsson
Children's Hospital Iceland, Landspítali - University Hospital, Reykjavík, Iceland
Search for more papers by this authorBirgitte Lausen
Department of Paediatrics, The University Hospital Rigshospitalet, Copenhagen, Denmark
Search for more papers by this authorJosefine Palle
Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden
Search for more papers by this authorBernward Zeller
Department of Paediatrics, Oslo University Hospital Rikshospitalet, Oslo, Norway
Search for more papers by this authorCorresponding Author
Henrik Hasle
Department of Paediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark
Correspondence Henrik Hasle, Department of Paediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark. Tel: +45 7845 1426; Fax: +45 7845 1477; e-mail: [email protected]Search for more papers by this authorNeval E. Wareham
Department of Paediatrics, The University Hospital Rigshospitalet, Copenhagen, Denmark
Search for more papers by this authorCarsten Heilmann
Department of Paediatrics, The University Hospital Rigshospitalet, Copenhagen, Denmark
Search for more papers by this authorJonas Abrahamsson
Department of Paediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
Search for more papers by this authorErik Forestier
Department of Medical Biosciences, Clinical Genetics, University of Umeå, Umeå, Sweden
Paediatric Haematology and Oncology, University Hospital of Umeå, Umeå, Sweden
Search for more papers by this authorBritt Gustafsson
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
Search for more papers by this authorShau-Yin Ha
Department of Paediatrics, Queen Mary Hospital and Hong Kong Paediatric Haematology & Oncology Study Group (HKPHOSG), Hong Kong, China
Search for more papers by this authorJesper Heldrup
Department of Paediatrics, University Hospital Lund, Lund, Sweden
Search for more papers by this authorKirsi Jahnukainen
Division of Haematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
Search for more papers by this authorÓlafur G. Jónsson
Children's Hospital Iceland, Landspítali - University Hospital, Reykjavík, Iceland
Search for more papers by this authorBirgitte Lausen
Department of Paediatrics, The University Hospital Rigshospitalet, Copenhagen, Denmark
Search for more papers by this authorJosefine Palle
Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden
Search for more papers by this authorBernward Zeller
Department of Paediatrics, Oslo University Hospital Rikshospitalet, Oslo, Norway
Search for more papers by this authorCorresponding Author
Henrik Hasle
Department of Paediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark
Correspondence Henrik Hasle, Department of Paediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark. Tel: +45 7845 1426; Fax: +45 7845 1477; e-mail: [email protected]Search for more papers by this authorAbstract
Background
Children with poor response acute myeloid leukaemia (AML) generally have a very poor outcome. Allogeneic stem cell transplantation (SCT) is often recommended for these children but the benefit is unclear. The aim of this study was to investigate survival for poor response AML patients treated with SCT.
Material and Methods
Treatment was given according to the NOPHO-AML 2004 protocol. All patients received AIET (Cytarabine, Idarubicin, Etoposide, Thioguanine) and AM (Cytarabine, Mitoxantrone) as induction. We included poor response defined as > 15% blasts on day 15 after AIET (n = 17) or > 5% blasts after AM (n = 14, refractory disease). Poor response patients received intensively timed induction and proceeded to SCT when a donor was available.
Results
Thirty-one of 267 evaluable patients (12%) had a poor response. SCT was performed in 25; using matched unrelated donors in 13, matched sibling donors in 6, cord blood donor in 4, and haploidentical donor in two. The median follow-up for the 31 poor responding patients was 2.6 years (range 0.4 - 8.1 years) and 3-year probability of survival 70% (95% CI 59-77%).
Conclusions
The poor responders in the NOPHO-AML 2004 protocol had a favourable prognosis treated with time-intensive induction followed by SCT.
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