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Improved treatment results in childhood acute nonlymphoblastic leukemia with the BFM-AML protocol 78 in a multicenter
Insights
This study evaluated the BFM 78 protocol for childhood acute myeloid leukemia (AML), finding a 5-year event-free survival of 36%. Results showed 70% achieved complete remission, but relapse and early complications were significant challenges.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Research
Background:
- Acute myeloid leukemia (AML) is a significant health concern in children.
- The BFM 78 protocol was developed to improve AML treatment outcomes.
- Multicenter studies are crucial for validating treatment efficacy across diverse populations.
Purpose of the Study:
- To evaluate the efficacy and outcomes of the AML protocol BFM 78 in children.
- To assess survival rates, remission achievement, and relapse frequencies.
- To compare results with previous studies and other AML treatment protocols.
Main Methods:
- A multicenter study involving 87 children diagnosed with acute nonlymphoblastic leukemia.
- Treatment administered according to the AML protocol BFM 78 between June 1979 and February 1986.
- Life table analysis used to determine event-free survival and interval probabilities at 5 years.
Main Results:
- Fifty-eight patients (70%) achieved complete remission; however, 17 children (20%) died from early complications.
- Twenty-three patients experienced relapse.
- The 5-year event-free survival probability was 36% (SD = 6%), with an event-free interval of 51% (SD = 8%).
- Six patients underwent transplantation in first remission, with two fatalities (encephalopathy and acute graft-versus-host disease).
Conclusions:
- The AML BFM 78 protocol demonstrated comparable results to the original BFM study, with variations noted in specific subtypes.
- Treatment outcomes were superior to other AML protocols utilized within the study group.
- Despite achieving complete remission in a majority of patients, challenges related to early mortality and relapse necessitate further research and protocol refinement.
Abstract:
Eighty-seven children with acute nonlymphoblastic leukemia were treated with the AML protocol BFM 78 between June 1979 and February 1986 in a multicenter study in the GDR. Seventeen children (20%) died from early complications, eight did not respond to therapy. Fifty-eight patients (70%) achieved a complete remission. Twenty-three patients relapsed. The life table analysis revealed after 5 years a probability for event-free survival of 36% (SD = 6%) and an event-free interval of 51% (SD = 8%). Six patients were transplanted in first remission. Two of them died; one (M 1) on day + 19 from encephalopathy and one (M 4) on day + 60 from acute GVHD. The overall results are in good correlation with the original BFM study, but there are differences in the subtypes. Results are superior to other AML protocols in our group.