Improved Treatment Results in High-Risk Pediatric Acute Myeloid Leukemia Patients After Intensification With High-Dose Cytarabine and Mitoxantrone: Results of Study Acute Myeloid Leukemia–Berlin-Frankfurt-Münster 93

• DOI: 10.1200/jco.2001.19.10.2705
• Publication Date: 2017-02-24T07:20:52Z
• Authors: U. Creutzig; J. Ritter; M. Zimmermann; D. Reinhardt; J. Hermann; F. Berthold; G. Henze; H. Jürgens; H. Kabisch; W. Havers; A. Reiter; U. Kluba; F. Niggli; H. Gadner
• Keywords: Mitoxantrone; Myeloid leukaemia

PURPOSE: To improve outcome in high-risk patients, high-dose cytarabine and mitoxantrone (HAM) was introduced into the treatment of children with acute myelogenous leukemia (AML) study AML-BFM 93. Patients were randomized to HAM as either second or third therapy block, for purpose evaluation efficacy toxicity. PATIENTS AND METHODS: A total 471 de novo AML entered onto trial; 161 at standard risk 310 high risk. After induction (daunorubicin v idarubicin), further therapy, exception HAM, identical two groups also comparable that Acute Myeloid Leukemia–Berlin-Frankfurt-Münster (AML-BFM) 87. RESULTS: Overall, 387 (82%) patients achieved complete remission, 5-year survival, event-free survival (EFS), disease-free rates 60%, 51%, 62%, respectively. Idarubicin resulted a significantly better blast cell reduction bone marrow on day 15. Estimated probability EFS superior 93 compared 87 (P = .01, log-rank test). This improvement, however, restricted (remission rate 87: 78% 68%, P .007; 44% 31%, Probability among standard-risk similar (65% 63%, not significant). Whether placed block minor importance. However, who received less intensive daunorubicin during benefited from early HAM. CONCLUSION: Improved results must be attributed mainly introduction