|
|
 Previous Article | Table of Contents | Next Article 
Blood, 15 October 2002, Vol. 100, No. 8, pp. 2708-2716
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Results of consecutive trials for children newly diagnosed with
acute myeloid leukemia from the Australian and New Zealand Children's
Cancer Study Group
Tracey A. O'Brien,
Susan
J. Russell,
Marcus R. Vowels,
Cecilia M. Oswald,
Karin Tiedemann,
Peter J. Shaw,
Liane Lockwood,
Lochie Teague,
Michael Rice, and
Glenn M. Marshall
From the Centre for Children's Cancer and Blood
Disorders, Sydney Children's Hospital, Randwick; Royal Children's
Hospital, Parkville, Melbourne; Children's Hospital at Westmead,
Sydney; Royal Children's Hospital, Brisbane; Women's and Children's
Hospital, Adelaide, Australia; and Starship Children's Hospital,
Auckland, New Zealand.
Despite improvements in the treatment of acute myeloid leukemia
(AML), approximately 50% of children die of the disease. Clinical trials in adult patients with AML indicate that idarubicin may have
superior efficacy when compared to daunorubicin in the
remission-induction phases of chemotherapy. We conducted consecutive
clinical trials in children with newly diagnosed AML in which
daunorubicin (group 1, n = 102) or idarubicin (group 2, n = 160)
was used during the remission-induction (RI) and the early
consolidation phases of chemotherapy. Idarubicin was given at a dose of
either 10 mg/m2 (group 2A, n = 106) or 12 mg/m2 (group 2B, n = 53). A high rate of RI was achieved
for all groups (95% group 1, 90% group 2A, 94% group 2B). There were
no significant differences in 5-year event-free survival (EFS) or in
overall survival (OS) when the 3 groups were compared (group 1: EFS
50%, OS 56%; group 2A: EFS 50%, OS 60%; group 2B: EFS 34%, OS
50%). RI deaths resulting from treatment toxicity were low 2% for
group 1 and 5% for group 2. More gastrointestinal, pulmonary, and
renal toxicity but fewer infections were observed in patients receiving idarubicin (P < .001, P = .04,
P = .03, respectively). Following RI chemotherapy, all
patients received 3 to 4 more courses of identical chemotherapy and
then underwent either autologous (n = 156) or an allogeneic bone
marrow transplantation (BMT) (n = 35). OS was higher in allogeneic
BMT patients than in autologous BMT patients (79% vs 63%;
P = .23). We conclude that daunorubicin is as effective
as idarubicin for remission-induction therapy for childhood AML
and has reduced toxicity.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
J. J. Ortega, L. Madero, G. Martin, A. Verdeguer, P. Garcia, R. Parody, J. Fuster, A. Molines, A. Novo, G. Deben, et al.
Treatment With All-Trans Retinoic Acid and Anthracycline Monochemotherapy for Children With Acute Promyelocytic Leukemia: A Multicenter Study by the PETHEMA Group
J. Clin. Oncol.,
October 20, 2005;
23(30):
7632 - 7640.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Tamm, S. Richter, D. Oltersdorf, U. Creutzig, J. Harbott, F. Scholz, L. Karawajew, W.-D. Ludwig, and C. Wuchter
High Expression Levels of X-Linked Inhibitor of Apoptosis Protein and Survivin Correlate with Poor Overall Survival in Childhood de Novo Acute Myeloid Leukemia
Clin. Cancer Res.,
June 1, 2004;
10(11):
3737 - 3744.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Lange, P. Dinndorf, F. O. Smith, C. Arndt, D. Barnard, S. Feig, J. Feusner, N. Seibel, M. Weiman, R. Aplenc, et al.
Pilot Study of Idarubicin-Based Intensive-Timing Induction Therapy for Children With Previously Untreated Acute Myeloid Leukemia: Children's Cancer Group Study 2941
J. Clin. Oncol.,
January 1, 2004;
22(1):
150 - 156.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C.-H. Pui, M. Schrappe, R. C. Ribeiro, and C. M. Niemeyer
Childhood and Adolescent Lymphoid and Myeloid Leukemia
Hematology,
January 1, 2004;
2004(1):
118 - 145.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
