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- Title
Treatment of childhood acute myeloblastic leukemia: dose intensification improves outcome and maintenance therapy is of no benefit – multicenter studies of the French LAME (Leucémie Aiguë Myéloblastique Enfant) Cooperative Group
- Authors
Perel, Y.; Auvrignon, A.; Leblanc, T.; Michel, G.; Reguerre, Y.; Vannier, J.-P.; Dalle, J.-H.; Gandemer, V.; Schmitt, C.; Méchinaud, F; Lejars, O; Piguet, C; Couillaud, G; Pautard, B; Landman-Parker, J; Thuret, I; Aladjidi, N; Baruchel, A; Leverger, G
- Abstract
From 1989 to 1998, 341 children were included in the French multicentric LAME (Leucémie Aiguë Myéloblastique Enfant) trials. A total of 309 children were registered in the LAME 89/91 protocol. This intensive regimen included an induction phase (mitoxantrone plus cytarabine), two consolidation courses, one containing timed-sequential high-dose cytarabine, asparaginase and amsacrine; 276 (90%) achieved a CR. The 5-year overall survival (OS) and event-free survival (EFS) were 60±4 and 48±4%, respectively. From 1997, timed-sequencing of the LAME SP induction chemotherapy led to an unacceptable frequency of consolidation delay; future improvements are unlikely to come from further increases in intensity. The role of allogenic bone-marrow transplantation from an HLA-identical sibling in CR1 was examined. The disease-free survival (DFS) was 52±4% for non-allografted patients and 57±7% for allografted patients (P=NS); a better OS for allografted patients was shown and could be related either to allo-BMT early in CR1 or to a second allo-BMT in CR2. For the complete responders after consolidation therapy, the 5-year OS was significantly better in patients randomized for no maintenance therapy (MT−) than in patients randomized for MT (77.6±8 vs 59±8%; P=0.05), while the 5-year DFS was not significantly different. Exposure to low-dose MT might contribute to clinical drug resistance and treatment failure in relapsing patients.Leukemia (2005) 19, 2082–2089. doi:10.1038/sj.leu.2403867; published online 25 August 2005
- Subjects
ACUTE myeloid leukemia in children; CANCER chemotherapy; LEUKEMIA in children; CHILDHOOD cancer; PEDIATRIC hematology; ACUTE myeloid leukemia; CANCER treatment; LEUKEMIA
- Publication
Leukemia (08876924), 2005, Vol 19, Issue 12, p2082
- ISSN
0887-6924
- Publication type
Article
- DOI
10.1038/sj.leu.2403867