Treatment of Acute Myeloid Leukaemia in Children

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Abstract
Complete remission was achieved in 11 of 22 children with acute myeloid leukemia using at least 2 courses of a 24 h infusion of cytosine arabinoside (Ara-C) 10 mg/kg, followed by push injections of daunorubicin (DNR) 45 mg/m2 and adriamycin (ADR) 45 mg/m2. Consolidation therapy consisted of 3 courses of Ara-C and 6-thioguanine (Tg) and 1 course of cyclophosphamide (CPA) and ADR. CNS prophylaxis with intrathecal Ara-C was given in all patients and cranial irradiation in 5. Maintenance therapy consisted of 5 day courses of Ara-C and Tg given 4 weekly with immunotherapy (BCG vaccine and s.c. leukemic cells) between courses. Median length of 1st complete remission was 99+ wk; median survival of all patients was 44 wk. Median survival of remitters was 195+ wk and non-remitters, 28 wk. Two patients developed CNS disease, 1 at presentation and the other 46 wk from presentation. Five patients have ceased therapy and remain in remission from 32-142 wk after ceasing treatment.