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Creutzig, U; Zimmermann, M; Dworzak, M; Urban, C; Henze, G; Kremens, B; Lakomek, M; Bourquin, JP; Stary, J; Reinhardt, D.
Favourable outcome of patients with childhood acute promyelocytic leukaemia after treatment with reduced cumulative anthracycline doses.
Br J Haematol. 2010; 149(3): 399-409. Doi: 10.1111/j.1365-2141.2010.08107.x [OPEN ACCESS]
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Co-authors Med Uni Graz
Urban Ernst-Christian
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Abstract:
Acute promyelocytic leukaemia (APL) treatment often includes high cumulative doses of anthracyclines, which can cause long-term cardiotoxicity. Here, we report the favourable outcome in 81 paediatric APL patients treated according to the consecutive acute myeloid leukaemia-Berlin/Frankfurt/Muenster (AML-BFM) trials -93/-98/-2004 with an anthracycline-cytarabine regimen in combination with all-trans-retinoid acid (ATRA). Outcomes achieved by treatment with a reduced cumulative anthracycline dose (350 mg/m(2)) were comparable to those reported for studies with higher doses. Five-year overall survival of the total cohort was 89 +/- 4% and event-free survival (pEFS) was 73 +/- 6%. Overall survival was similar when comparing AML-BFM trial periods (trial 93: 88 +/- 8%, 98: 85 +/- 7% and 2004: 94 +/- 8%, P((logrank)) = 0.63). Seventy-five (93%) patients achieved complete remission. Most fatal events occurred during the first 6 weeks of treatment. Long-term cardiotoxicity was observed in one patient. Two patients suffered from secondary haematological malignancies. Salvage treatment was effective in 7/9 patients (78%) with relapsed APL, who now are long-term survivors after second line combination treatment with arsenic trioxide (4/7 patients) and stem cell transplantation (5/7 patients). Our results demonstrate that - combined with ATRA - a lower cumulative anthracycline dose can be used safely to maintain high cure rates and promote the reduction of long-term sequelae, such as cardiotoxicity in APL patients.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent -
Anthracyclines - administration and dosage
Antineoplastic Combined Chemotherapy Protocols - administration and dosage
Cardiomyopathies - chemically induced
Child -
Child, Preschool -
Cytarabine - administration and dosage
Drug Administration Schedule -
Female -
Humans -
Infant -
Infant, Newborn -
Leukemia, Promyelocytic, Acute - drug therapy
Male -
Neoplasms, Second Primary - chemically induced
Recurrence -
Survival Analysis -
Treatment Outcome -
Tretinoin - administration and dosage

Find related publications in this database (Keywords)
acute promyelocytic leukaemia
children
therapy
anthracyclines
cardiotoxicity
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