IMPROVED TREATMENT RESULTS IN CHILDHOOD ACUTE MYELOGENOUS LEUKEMIA - A REPORT OF THE GERMAN COOPERATIVE STUDY AML-BFM-78

  • 1 January 1985
    • journal article
    • research article
    • Vol. 65  (2) , 298-304
Abstract
Children (151) with acute myelogenous leukemia (AML) entered the cooperative study BFM-78 between Dec. 1978 and Oct. 1982. The initial therapy consisted of an intensive induction and consolidation regimen over 8 wk with 7 different drugs and cranial irradiation. It was followed by maintenance with thioguanine and cytosine arabinoside for 2 yr and additional Adriamycin during the 1st yr. One hundred nineteen (79%) patients achieved a complete remission. Thirteen (9%) children died of early hemorrhages. After a median follow-up time of 36 (12-57) mo., 47 relapses have occurred, with CNS involvement in 7 cases. The life table analysis revealed a probability for overall survival after almost 5 yr of 45% (SD, 4%), for event-free survival 41% (SD, 4%), and for the event-free interval 52% (SD, 5%). Up to now, no relapse was seen after 2 1/2 yr. Risk factor analysis showed that early fatal hemorrhages occurred predominantly in children with M5 FAB type and with initial leukocytosis. An initial high WBC [white blood cell] count and liver enlargement were unfavorable parameters for achieving remission. No factors could be identified concerning the risk for relapse. The applied treatment strategy apparently is successful in inducing complete remissions in about 3/4 of children with AML and also in enhancing considerably the chances for long-term remission.