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Blood, 15 March 2007, Vol. 109, No. 6, pp. 2314-2321. Prepublished online as a Blood First Edition Paper on December 7, 2006; DOI 10.1182/blood-2005-11-025536. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2005-11-025536v1 109/6/2314    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Barbaric, D. Articles by Smith, F. O. Search for Related Content PubMed PubMed Citation Articles by Barbaric, D. Articles by Smith, F. O. Related Collections Clinical Trials and Observations Neoplasia Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Minimally differentiated acute myeloid leukemia (FAB AML-M0) is associated with an adverse outcome in children: a report from the Children's Oncology Group, studies CCG-2891 and CCG-2961 Draga Barbaric1, Todd A. Alonzo2,3, Robert B. Gerbing3, Soheil Meshinchi4, Nyla A. Heerema5, Dorothy R. Barnard6, Beverly J. Lange7, William G. Woods8, Robert J. Arceci9, and Franklin O. Smith10 1 Division of Hematology/Oncology/BMT, BC's Children's Hospital, Vancouver, BC, Canada; 2 Department of Preventive Medicine, University of Southern California, Los Angeles; 3 Children's Oncology Group, Arcadia, CA; 4 Fred Hutchinson Cancer Research Center, Seattle, WA; 5 Department of Pathology, Ohio State University, Columbus; 6 Division of Pediatric Hematology/Oncology, IWK Health Center, Halifax, NS, Canada; 7 Pediatric Oncology, Children's Hospital of Philadelphia, PA; 8 AFLAC Cancer Center and Blood Disorders Service, Children's Healthcare of Atlanta, GA; 9 Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; 10 Division of Hematology/Oncology, Cincinnati Children's Hospital Medical Center and The University of Cincinnati College of Medicine, OH To assess the impact of minimally differentiated acute myeloid leukemia (AML-M0) morphology in children, we analyzed 2 sequential Children's Cancer Group AML clinical trials. We compared presenting characteristics and outcomes of 82 CCG-2891 and CCG-2961 patients with de novo, non–Down syndrome (DS) AML-M0 with those of 1620 patients with non-M0 AML, and of 10 CCG-2891 patients with DS-associated AML-M0 with those of 179 with DS-associated non-M0 AML. Morphology and cytogenetics were centrally reviewed. The non-DS AML-M0 children had a lower white blood cell (WBC) count (P = .001) than their non-M0 counterparts and a higher incidence of chromosome 5 deletions (P = .002), nonconstitutional trisomy 21 (P = .027), and hypodiploidy (P = .002). Outcome analyses considering all children with non-DS AML demonstrated no significant differences between M0 and non-M0 patients. Analyses restricted to intensive-timing CCG-2891 and CCG-2961 demonstrated comparable complete response (CR) rates (79% and 78%) between non-DS M0 and non-M0 patients. Overall survival (OS) from diagnosis (38% ± 14% versus 51% ± 3%; P = .160) was not significantly different between the 2 groups. OS from end of induction (45% ± 17% versus 63% ± 3%; P = .038), event-free survival (EFS; 23% ± 11% versus 41% ± 3%; P = .018), and disease-free survival (DFS; 31% ± 14% versus 52% ± 3%; P = .009) were inferior in the M0 group. There was no significant outcome difference between DS-associated AML-M0 and non-M0 children. This study suggests that intensively treated non–DS-associated AML-M0 children have an inferior outcome compared with children with non-M0 AML. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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