TREATMENT
RESPONSIVENESS OF CHILDHOOD ACUTE MYELOGENOUS LEUKEMIA
Zhang Y-H, Xu U-N, Zho X-M, Wu M-Y, Hu Y-M
Beijing Children's Hospital, Beijing, China
Objective: To investigate the
treatment responsiveness and prognostic factors of childhood acute myelogenous
leukemia.
Methods: 56 children with acute
myelogenous leukemia diagnosed between 1993-1999 received three types of
chemotherapy in induce remission and were retrospectively analyzed. Group A
received modified BFM protocol; Group B received DA or IA for induction;
Group C received ATRA for induction.
Results: The median age was 8
years. Male: female is 1:1. M2 was the commonest subtype (50%). The
incidence of M3,M4 and M5 were 13%, respectively. Twenty cases were
hyperleukocytosis(36%) and 2 with extramedullary involvement. Eighteen
patients (32.1%) were Auer rods positive. All patients received three types
of combination chemotherapy, respectively, DA or IA for 30 patients and BFM
for 21 patients. All 5 patients of M3 received ATRA induction. Complete
remission (CR) rates were all above 95%. The difference of CR
times(19.6±7.7days Vs 32.8±19.4days), relapse rate（14% Vs 21%）of group A
and group B are apparent. The treatment responsiveness of group by BFM was
better than that by DA or IA. The rate of complications in period of
induction and maintenance were 36% and 32%, respectively. The infection was
the commonest complications. Early deaths and non-Leukaemia deaths during
remission occurred in 12 patients. The times of disease free survival (3 years
and 3 months Vs 3 years and 8 months) and the rates of disease free
survival of two groups were 80% and71.4%, respectively and no apparent
difference.
Conclusion: Complete remission
times and the relapse rate of group A (modified BFM) were less than that of
group B(DA or IA). However, the status of disease free survival needs more
investigation.