| 51. |
- Wareham, Neval E., et al.
(författare)
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Outcome of poor response paediatric AML using early SCT
- 2013
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Ingår i: European Journal of Haematology. - : Wiley. - 1600-0609 .- 0902-4441. ; 90:3, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- 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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| 52. |
- Wendtland Edslev, Pernille, et al.
(författare)
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Age and Prognosis in Pediatric AML
- 2008
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Ingår i: Blood. - 1528-0020 .- 0006-4971. ; 112:11
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Konferensbidrag (refereegranskat)
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| 53. |
- Wennström, Lovisa, et al.
(författare)
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Acute Myeloid Leukemia in Adolescents and Young Adults Treated in Pediatric and Adult Departments in the Nordic Countries
- 2016
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Ingår i: Pediatric Blood & Cancer. - : Wiley-Blackwell. - 1545-5009 .- 1545-5017. ; 63:1, s. 83-92
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies on adolescents and young adults with acute lymphoblastic leukemia suggest better results when using pediatric protocols for adult patients, while corresponding data for acute myeloid leukemia (AML) are limited. Procedure: We investigated disease characteristics and outcome for de novo AML patients 10-30 years old treated in pediatric or adult departments. We included 166 patients 10-18 years of age with AML treated according to the pediatric NOPHO-protocols (1993-2009) compared with 253 patients aged 15-30 years treated in hematology departments (1996-2009) in the Nordic countries. Results: The incidence of AML was 4.9/million/year for the age group 10-14 years, 6.5 for 15-18 years, and 6.9 for 19-30 years. Acute promyelocytic leukemia (APL) was more frequent in adults and in females of all ages. Pediatric patients with APL had similar overall survival as pediatric patients without APL. Overall survival at 5 years was 60% (52-68%) for pediatric patients compared to 65% (58-70%) for adult patients. Cytogenetics and presenting white blood cell count were the only independent prognostic factors for overall survival. Age was not an independent prognostic factor. Conclusions: No difference was found in outcome for AML patients age 10-30 years treated according to pediatric as compared to adult protocols.
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| 54. |
- Wilhelmson, Mari, et al.
(författare)
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Hospitalizations in Long-term Survivors of Childhood AML Treated with Allogeneic HSCT - an Adult Life after Childhood Cancer in Scandinavia (ALiCCS) Study
- 2019
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Ingår i: 38th NOPHO Annual meeting. Aalborg, Denmark 3-7 May.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is effective in treating childhood acute myeloid leukemia (AML) but the long-term disease burden may be increased. In a population-based study, the standardized hospitalization rates ratios (SHRR) and absolute excess risks for disease specific hospitalizations were evaluated in 5-year survivors of AML treated at 0-17 years of age according to the NOPHO-AML protocols in four Nordic countries during 1984-2005. In total, 229 eligible AML survivors were identified in the NOPHO-AML database and the treatment data of 196 survivors could be linked to 5-year follow-up data in national hospital registries. After a median follow-up time of 12 (range 5–28) years, 35 out of the 97 survivors treated with allo-HSCT had been hospitalized (SHRR 2.8 (95% CI 2.0– 4.0) with increased risk for hospitalizations due to cardiovascular 8.7 (3.9–19), endocrine 12 (6.7–22), pulmonary 3.0 (1.8–5.2), gastrointestinal 4.0 (2.4–6.7), infectious 3.1 (1.3–7.6), neurological 4.4 (2.1–9.2) and uro-genital system conditions 2.9 (1.3–6.4). In comparison, after a median follow-up time of 11 (range 5–28) years, 21 out of the 99 survivors treated with chemotherapy alone had been hospitalized; SHRR 1.4 (0.9–2.1). Our results indicate that hospitalization rates are significantly increased in long-term survivors of childhood AML if treated with allo-HSCT but not in survivors treated with chemotherapy only.
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| 55. |
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| 56. |
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| 57. |
- Wilhelmsson, Mari, et al.
(författare)
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Long-term health outcomes in survivors of childhood AML treated with allogeneic HSCT: a NOPHO-AML Study.
- 2019
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Ingår i: Bone marrow transplantation. - : Springer Science and Business Media LLC. - 1476-5365 .- 0268-3369. ; 54:726-736
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Tidskriftsartikel (refereegranskat)abstract
- Allogeneic hematopoietic stem cell transplantation (allo-HSCT) improves event-free survival in acute myeloid leukemia (AML); however, the burden of late effects may be increased. We compared health-related outcomes in childhood AML survivors treated according to the NOPHO-AML protocols either with or without allo-HSCT at age<21 years. Out of the 147 eligible AML survivors treated with allo-HSCT, 95 (65%) and 53 (75%) of their eligible siblings completed a questionnaire. Their data were compared to corresponding data collected previously from NOPHO-AML survivors treated with chemotherapy only (CT) (n=101). The median follow-up was 12 (range 2-28) years after allo-HSCT and 47% had received total body irradiation (TBI)-based conditioning. Allo-HSCT survivors reported significantly more physical health limitations (39% vs 7%, p<0.005), medications for cardiovascular disease (10% vs 1%, p<0.05) and use of analgesics (32% vs 11%, p<0.01) than CT survivors. Health problems prevented 16% of the allo-HSCT survivors from attending school or managing a job vs. 3% among CT survivors (p<0.05). Among 73 allo-HSCT survivors (age≥15 years), seven females reported natural pregnancies and three males reported unassisted conceptions in partners. Survivors of childhood AML treated with allo-HSCT experienced more physical health limitations and used more medications than the survivors treated with chemotherapy only.
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| 58. |
- Zeller, Bernward, et al.
(författare)
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Hyperleucocytosis in paediatric acute myeloid leukaemia : the challenge of white blood cell counts above 200 x 109/l. The NOPHO experience 1984-2014
- 2017
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Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 178:3, s. 448-456
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Tidskriftsartikel (refereegranskat)abstract
- Hyperleucocytosis in paediatric acute myeloid leukaemia (AML) is associated with increased morbidity and mortality. We studied hyperleucocytosis in 890 patients with AML aged 0-18 years registered in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) registry, with special focus on very high white blood cell counts (WBC > 200 x 10/l). Eighty-six patients (10%) had WBC 100-199 x 109/l and 57 (6%) had WBC >= 200 x 109/l. Patients with WBC >= 200 x 109/l had a high frequency of t(9;11) and a paucity of trisomy 8. Due to the high frequency of deaths within the first 2 weeks (30% vs. 1% for all others), overall survival in this group was inferior to patients with WBC <200 x 109/l (39% vs. 61%). Main cause of early death was intracranial haemorrhage and leucostasis. Twenty-six per cent of these patients never started antileukaemic protocol therapy. Leukapheresis or exchange transfusion was used in 24% of patients with hyperleucocytosis without impact on survival. Patients with hyperleucocytosis surviving the first week had identical survival as patients with lower WBC. We conclude that death within the first days after diagnosis is the major challenge in patients with high WBC and advocate rapid initiation of intensive chemotherapy.
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