Open AccessThe results of treatment in children with AML and initial hyperleucocytosis according to the AML-MM-2006 Protocol
Author(s) -
И. И. Калинина,
Н. В. Захаров,
Д. А. Венёв,
Т. Ю. Салимова,
У. Н. Петрова,
О. В. Горонкова,
Д. Д. Байдильдина,
Е.В. Сунцова,
М. Н. Садовская,
Д. А. Евсеев,
V.E. Matveev,
К. С. Антонова,
И. Г. Хамин,
М. Э. Дубровина,
Ю. В. Ольшанская,
Elena Zerkalenkova,
А. И. Манджиева,
Dmitry Balashov,
Anna Shcherbina,
Michael Maschan,
Galiovichkova,
Alexey Maschan
Publication year - 2020
Publication title -
voprosy gematologii/onkologii i immunopatologii v pediatrii
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.108
H-Index - 3
eISSN - 2414-9314
pISSN - 1726-1708
DOI - 10.24287/1726-1708-2020-19-1-9-17
Subject(s) - medicine , gastroenterology , complete remission , hematology , leukostasis , pediatrics , leukemia , chemotherapy
The prognostic role of HL in AML in children is a matter of a discussion. 185 patients were treated for AML in our center, 36 of 185 had HL (19.5%). The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. Median Le was 97 × 109 /l (50–428 ± 109 /l). Standard risk group were 4 pts, intermediate – 8, hight – 24. The most common variants were M4/M5 in FAB classification – 30 pts and genetic rearrangement – MLL in 15 of 36 pts. Thirty-five patients with HL received cytoreduction course and ADE. After that, all patients received ADE and 21 pts second part of induction – course HAM. Remission was achieved in 27 (75%) out of 36 pts. HSCT was performed in 23 pts. Thirteen out of 36 patients with HL died: 4 (30%) – due to leukostasis complications. OS for HL group was 0.56 ± 0.09, for non-HL group was 0.75 ± 0.04, p = 0.005; EFS (HL) 0.42 ± 0.09, EFS (non-HL) 0.49 ± 0.04, p = 0.026. Also, differences in I CR achievement, median of remission length and death before remission between two groups were statistically significant (p = 0.036; p = 0.028; p = 0.021 respectively). OS and EFS in patients with M4/M5 with HL > 50 ± 109 /l were better than in patients all FAB with HL > 100 ± 109 /l, OS 0.71 ± 0.1 vs OS 0.43 ± 0.1 (p = 0.012); EFS 0.54 ± 0.1 vs EFS 0.29 ± 0.1 (p = 0.038) respectively. HL significantly worsens OS and EFS in children with AML.