Abstract
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.
Highlights
ФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им
The results of treatment in children with AML and initial hyperleucocytosis according to the AML-MM-2006 Protocol
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%)
Summary
Результаты терапии детей с острым миелоидным лейкозом и инициальным гиперлейкоцитозом. Чаще встречался М5/М4 вариант ОМЛ по FAB-классификации – 30 пациентов. У пациентов с М4/М5, получающих циторедукцию при уровне лейкоцитов более 50 ± 109/л, показатели OS и EFS были лучше, чем у пациентов с лейкоцитами более 100 ± 109/л во всей группе: OS – 0,71 ± 0,1 и 0,43 ± 0,1 (p = 0,012); EFS – 0,54 ± 0,1 и 0,29 ± 0,1 (p = 0,038) соответственно. The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. All patients received ADE and 21 pts second part of induction – course HAM. На начальном этапе терапии самый грозный фактор риска ранней летальности – гиперлейкоцитоз (ГЛ), который встречается у 5–20% пациентов с первично диагностированным ОМЛ. В данной статье мы анализируем исходы терапии пациентов с впервые диагностированным ОМЛ и инициальным ГЛ, получавших лечение согласно единому протоколу в крупном специализированном центре детской гематологии/онкологии
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