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[Myelogenous leukemia in children. ANLL9205 study by Children's Cancer and Leukemia Study Group (CCLSG)]
J Mimaya1, Y Horikoshi, H Shimizu
1Division of Hemotology and Oncology, Shizuoka Children's Hospital.
Insights
The ANLL-9205 protocol effectively treats childhood acute myeloblastic leukemia (AML), achieving an 88.4% remission rate. This treatment is safe and shows no significant difference in outcomes between 32 and 48-week durations.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Trials
Background:
- Acute Myeloblastic Leukemia (AML) is a significant challenge in pediatric oncology.
- Effective treatment protocols are crucial for improving survival rates in children with AML.
Purpose of the Study:
- To evaluate the efficacy and safety of the ANLL-9205 protocol for childhood AML.
- To assess the impact of treatment duration (32 vs. 48 weeks) on event-free survival.
Main Methods:
- A cohort of 45 children with AML was treated using the ANLL-9205 protocol.
- The protocol involved remission induction with terarubicin (THP-ADR), vincristine, and continuous cytosine arabinoside (Ara C) infusion (AVC).
- Consolidation therapy included VP16 and high-dose Ara C for 32 or 48 weeks; 11 patients underwent stem cell transplantation.
Main Results:
- Complete remission was achieved in 88.4% (38/43) of eligible patients.
- The 3-year event-free survival (EFS) was 55.6% (±10%).
- Favorable responses were noted in M5, M7 FAB subtypes and patients with higher WBC counts; no significant difference in 3-year EFS was observed between 32 and 48-week treatment durations.
Conclusions:
- The ANLL-9205 protocol demonstrates effectiveness and safety in treating childhood AML.
- The protocol achieves a high remission rate and acceptable long-term survival.
- Treatment duration of 32 or 48 weeks did not significantly impact EFS in this study.
Abstract:
Treatment results were evaluated in 45 children with acute myeloblastic leukemia (AML) treated on the ANLL-9205 protocol of the Children's Cancer Leukemia Study Group (CCLSG, Japan). In this protocol, terarubicin (THP-ADR), vincristine and continuous infusion of cytosine arabinoside (Ara C) were applied for remission induction therapy (AVC), and VP16+ high dose Ara C were used sequentially for 32 or 48 weeks. Eleven patients received stem cell transplantation. Thirty-eight out of the 43 eligible patients (88.4%) achieved complete remission, and the overall 3-year event-free survival (EFS) was 55.6% (S.E.,10%). This favorable response was attributed mainly to the high induction rate of patients with the M5, M7 FAB subtypes and higher WBC counts (> or = 10 x 10(9)/L). There was no difference in the 3-year EFS of these patients who discontinued treatment between 32 weeks and 48 weeks. Serious toxicities were not observed in this study. These findings suggest that the ANLL-9205 protocol is an effective and safe treatment regimen for childhood AML. When comparing the treatment period of 32 or 48 weeks, the difference was not statistically significant.