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Results of intensive chemotherapy in children with juvenile chronic myelomonocytic leukemia: a pilot study
C Díaz de Heredia1, J J Ortega, M T Coll
1Department of Hematology/Oncology, Hospital Universitario Materno-Infantil Vall d'Hebron, Barcelona, Spain. jortega.hmi@cs.vhebron.es
Background:
The use of chemotherapy in juvenile chronic myelomonocytic leukemia (J-CMML) has not generally been successful. Our previous experience in 11 patients demonstrated that chemotherapy with low doses of daunorubicin or cytarabine resulted in a 90% fatal outcome and a median survival rate of only 7 months.
Procedure And Results:
Between 1985 and 1997, six children (five boys and one girl) aged 3-67 months (median age: 20.5) were diagnosed with J-CMML and underwent intensive combination chemotherapy similar to that used for acute myeloblastic leukemia. Two patients with high-risk factors developed progressive disease with fatal outcome at 5 and 18 months postdiagnosis, respectively. However, four patients without poor prognosis indices responded and were alive 145, 82, 51, and 6 months after diagnosis. Overall survival in this small series at 7 years from diagnosis is 60% (CI: 17-100).
Conclusions:
The use of intensive combination chemotherapy in children with J-CMML can result in long-term survival in some patients.