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Characteristics and outcome of primary resistant disease in paediatric acute myeloid leukaemia

Karlsson, Lene (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Department of Pediatrics, Institution for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Pediat, Gothenburg, Sweden.
Cheuk, D. (author)
Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital and Hong Kong Pediatric Hematology and Oncology Study Group (HKPHOSG), Hong Kong,Hong Kong Childrens Hosp, Dept Pediat & Adolescent Med, Hong Kong, Peoples R China.;Hong Kong Pediat Hematol & Oncol Study Grp HKPHOSG, Hong Kong, Peoples R China.
De Moerloose, B. (author)
Department of Pediatric Hematology-Oncology, Ghent University Hospital, Ghent, Belgium,Ghent Univ Hosp, Dept Pediat Hematol Oncol, Ghent, Belgium.
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Hasle, H. (author)
Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark,Aarhus Univ Hosp, Dept Pediat & Adolescent Med, Aarhus, Denmark.
Jahnukainen, K. (author)
New Children's hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland,Univ Helsinki, New Childrens Hosp, Pediat Res Ctr, Helsinki, Finland.;Helsinki Univ Hosp, Helsinki, Finland.
Juul-Dam, K. L. (author)
Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark,Aarhus Univ Hosp, Dept Pediat & Adolescent Med, Aarhus, Denmark.
Kaspers, G. (author)
Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands; Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Amsterdam, Netherlands,Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands.;Vrije Univ Amsterdam, Emma Childrens Hosp, Amsterdam UMC, Pediat Oncol, Amsterdam, Netherlands.
Kovalova, Z. (author)
Department of Paediatric Oncology/Haematology, Children's Clinical University Hospital, Riga, Latvia,Childrens Clin Univ Hosp, Dept Paediat Oncol Haematol, Dept Pathobiol & Lab Med, Riga, ON, Latvia.
Lausen, B. (author)
Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,Univ Copenhagen, Dept Pediat & Adolescent Med, Rigshosp, Copenhagen, Denmark.
Norén-Nyström, Ulrika (author)
Umeå universitet,Pediatrik,Umeå Univ, Dept Clin Sci, Pediat, Pediat Hematol & Oncol, Box 400, S-40530 Umeå, Sweden.
Palle, Josefine, 1964- (author)
Uppsala universitet,Barnonkologisk och neurologisk forskning
Pronk, C. J. (author)
Childhood Cancer Center, Skåne University Hospital, Lund, Sweden,Skane Univ Hosp, Childhood Canc Ctr, Lund, Sweden.
Saks, K. (author)
Department of Paediatrics, SA Tallinna Lastehaigla, Tallinn, Estonia,SA Tallinna Lastehaigla, Dept Paediat, Tallinn, Estonia.
Tierens, A. (author)
Department of Pathobiology and Laboratory Medicine, University Health Network, Toronto General Hospital, ON, Toronto, Canada
Zeller, B. (author)
Department of Pediatrics, Oslo University Hospital, Oslo, Norway
Abrahamsson, Jonas, 1954 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Department of Pediatrics, Institution for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Pediat, Gothenburg, Sweden.
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 (creator_code:org_t)
2023-02-10
2023
English.
In: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 201:4, s. 757-765
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • A significant proportion of events in paediatric acute myeloid leukaemia (AML) are caused by resistant disease (RD). We investigated clinical and biological characteristics in 66 patients with RD from 1013 children with AML registered and treated according to the NOPHO-AML 93, NOPHO-AML 2004, DB AML-01 and NOPHO-DBH AML 2012 protocols. Risk factors for RD were age10 years or older and a white-blood-cell count (WBC) of 100 x 10(9)/L or more at diagnosis. The five-year overall survival (OS) was 38% (95% confidence interval [CI]: 28%-52%). Of the 63 children that received salvage therapy with chemotherapy, 59% (N = 37) achieved complete remission (CR) with OS 57% (95% CI: 42%-75%) compared to 12% (95% CI: 4%-35%) for children that did not achieve CR. Giving more than two salvage chemotherapy courses did not increase CR rates. OS for all 43 patients receiving allogeneic haematopoietic stem cell transplantation (HSCT) was 49% (95% CI: 36%-66%). Those achieving CR and proceeding to HSCT had an OS of 56% (95% CI: 41%-77%, N = 30). This study showed that almost 40% of children with primary resistant AML can be cured with salvage therapy followed by HSCT. Children that did not achieve CR after two salvage courses with chemotherapy did not benefit from additional chemotherapy.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Hematologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Hematology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

acute myeloid leukaemia
paediatric
resistant disease
survival
children
childhood
therapy
flt3/itd
trial
Hematology
acute myeloid leukaemia

Publication and Content Type

ref (subject category)
art (subject category)

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