Results of Chemotherapy with BFM-87 Protocol in Children with Acute Myeloid Leukemia at a Referral Center in the Southwest of Iran: Clinical Characteristics and Outcome

AUTHORS

Mohammad Pedram 1 , * , AA Hiradfar 2

1 Pediatric oncologist, Shafa hospital, Research Center of Thalassemia and Hemoglobinopathy, Ahwaz Jondishapoor Medical University, Iran

2 Pediatric hematology and oncology fellowship, Shafa hospital, Ahwaz Jondishapoor Medical University, Iran

How to Cite: Pedram M , Hiradfar A. Results of Chemotherapy with BFM-87 Protocol in Children with Acute Myeloid Leukemia at a Referral Center in the Southwest of Iran: Clinical Characteristics and Outcome , Int J Cancer Manag. 2009 ; 2(3):e80573.

ARTICLE INFORMATION

International Journal of Cancer Management: 2 (3); e80573
Published Online: September 30, 2009
Article Type: Research Article
Received: September 30, 2009
Accepted: September 30, 2009

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Abstract

Introduction: Leukemia is the most common malignancy in childhood, and acute myeloid leukemia (AML) is the second most common leukemia. AML still accounts for more than 30% of deaths from leukemia. AML is classified into several subgroups from M0 to M7 with different presentations, clinical features, and outcomes.

Material and Methods: Between March 1996 and October 2003, 47 children with acute myeloid leukemia were treated with intensive chemotherapy using BFM-87 protocol after remission at Shafa hospital, Ahwaz, Iran. We compared the presenting features and outcomes of therapy in these children based on age, initial White Blood Cells (WBC) count, Central Nervous System involvement, FAB system types, and response to first induction treatment.

Results: Younger children were more likely to have favourable risks and less likely to have induction deaths (p=0.03) and lower relapse risks (p=0.001). FAB types M2 and M4 showed a better first remission rate (p=0.01, p=0.02, respectively), regardless of age and gender. Two major risk factors for relapse after first remission were initial high WBC counts (p=0.01) and older age at the time of diagnosis (p=0.02). Overall survival (p=0.001), event-free survival (p=0.001), and disease-free survival were better (p<0.001) in younger children due to lower relapse rates (p=0.001). Discussion: Overall survival was 53% in the children with new AML who were on intensive chemotherapy with a median follow-up time of 5 years in our study. Relapse risk after first remission for the children who were on intensive chemotherapy alone was 34% in our study.

Conclusion: Because of the potential morbidity and mortality usually related to allogeneic HSCT and also problems due to lack of sufficient HSCT possibility for some patients, several cooperative group trials now do not recommend HSCT for good- or standard- risk patients in their first remission. Results of our study were compatible with BFM , AML 10 and AML 12 groups trials in terms of overall survival, or relapse risk, or induction death risk factors

Keywords

myeloid leukemia survival chemotherapy

© 2009, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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