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Improved treatment results in childhood acute myelogenous leukemia: a
report of the German cooperative study AML-BFM-78
U Creutzig, J Ritter, H Riehm, HJ Langermann, G Henze, H Kabisch, D Niethammer, H Jurgens, B Stollmann and U Lasson
One hundred fifty-one children with acute myelogenous leukemia (AML)
entered the cooperative study BFM-78 between December 1978 and October
1982. The initial therapy consisted of an intensive induction and
consolidation regimen over eight weeks with seven different drugs and
cranial irradiation. It was followed by maintenance with thioguanine and
cytosine arabinoside for two years and additional Adriamycin during the
first year. 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 to 57) months, 47 relapses have occurred, with CNS
involvement in seven cases. The life table analysis revealed a probability
for overall survival after almost five years 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 years. Risk factor analysis
showed that early fatal hemorrhages occurred predominantly in children with
M5 FAB type and with initial leukocytosis. An initial high WBC count and
liver enlargement were unfavorable parameters for achieving remission. No
factors could be identified concerning the risk for relapse. These data
indicate that the applied treatment strategy is successful in inducing
complete remissions in about three fourths of children with AML and also in
enhancing considerably the chances for long-term remission.
Volume 65,
Issue 2,
pp. 298-304,
02/01/1985
Copyright © 1985 by The American Society of Hematology
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