Favorable outcome in infants with AML after intensive first- and second-line treatment: An AML-BFM study group report

U. Creutzig; M. Zimmermann; J. P. Bourquin; M. N. Dworzak; B. Kremens; T. Lehrnbecher; C. Von Neuhoff; A. Sander; A. Von Stackelberg; I. Schmid; J. Starý; D. Steinbach; J. Vormoor; D. Reinhardt

doi:10.1038/leu.2011.267

Favorable outcome in infants with AML after intensive first- and second-line treatment: An AML-BFM study group report

U. Creutzig, M. Zimmermann, J. P. Bourquin, M. N. Dworzak, B. Kremens, T. Lehrnbecher, C. Von Neuhoff, A. Sander, A. Von Stackelberg, I. Schmid, J. Starý, D. Steinbach, J. Vormoor, D. Reinhardt

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Abstract

Infants <1 year of age have a high prevalence of prognostically unfavorable leukemias and a presumed susceptibility to treatment-related toxicities. A total of 125 infants with acute myeloid leukemia (AML) were treated in studies AML-BFM-98 (n=59) and -2004 (n=66). Treatment regimens of both studies were comparable, consisting of intensive induction followed by four courses (mainly high-dose cytarabine and anthracyclines). Allogeneic- hematopoietic stem-cell-transplantation (allo-HSCT) in 1st remission was optional for high-risk (HR) patients. Most infants (120/125=96%) were HR patients according to morphological, cytogenetic/molecular genetic and response criteria. Five-year overall survival was 66±4%, and improved from 61±6% in study-98 to 75±6% in study-2004 (P_logrank 0.14) and event-free survival rates were 44±6% and 51±6% (P _logrank 0.66), respectively. Results in HR infants were similar to those of older HR children (1-<2- or 2-<10-year olds, P_logrank 0.90 for survival). Survival rates of HSCT in 1st remission, initial partial response and after relapse were high (13/14, 2/8 and 20/30 patients, respectively). The latter contributes to excellent 5-year survival after relapse (50±8%). Despite more severe infections and pulmonary toxicities in infants, treatment-related death rate was identical to that of older children (3%). Our data indicate that intensive frontline and relapse AML treatment is feasible in infants, toxicities are manageable, and outcome is favorable.

Original language	English
Pages (from-to)	654-661
Number of pages	8
Journal	Leukemia
Volume	26
Issue number	4
DOIs	https://doi.org/10.1038/leu.2011.267
Publication status	Published - Apr 2012
Externally published	Yes

Keywords

acute myeloid leukemia
children
infants
treatment

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10.1038/leu.2011.267

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Creutzig, U., Zimmermann, M., Bourquin, J. P., Dworzak, M. N., Kremens, B., Lehrnbecher, T., Von Neuhoff, C., Sander, A., Von Stackelberg, A., Schmid, I., Starý, J., Steinbach, D., Vormoor, J., & Reinhardt, D. (2012). Favorable outcome in infants with AML after intensive first- and second-line treatment: An AML-BFM study group report. Leukemia, 26(4), 654-661. https://doi.org/10.1038/leu.2011.267

@article{6aed2a3ab8a34f50b1ddc5007eead3ed,

title = "Favorable outcome in infants with AML after intensive first- and second-line treatment: An AML-BFM study group report",

abstract = "Infants <1 year of age have a high prevalence of prognostically unfavorable leukemias and a presumed susceptibility to treatment-related toxicities. A total of 125 infants with acute myeloid leukemia (AML) were treated in studies AML-BFM-98 (n=59) and -2004 (n=66). Treatment regimens of both studies were comparable, consisting of intensive induction followed by four courses (mainly high-dose cytarabine and anthracyclines). Allogeneic- hematopoietic stem-cell-transplantation (allo-HSCT) in 1st remission was optional for high-risk (HR) patients. Most infants (120/125=96\%) were HR patients according to morphological, cytogenetic/molecular genetic and response criteria. Five-year overall survival was 66±4\%, and improved from 61±6\% in study-98 to 75±6\% in study-2004 (Plogrank 0.14) and event-free survival rates were 44±6\% and 51±6\% (P logrank 0.66), respectively. Results in HR infants were similar to those of older HR children (1-<2- or 2-<10-year olds, Plogrank 0.90 for survival). Survival rates of HSCT in 1st remission, initial partial response and after relapse were high (13/14, 2/8 and 20/30 patients, respectively). The latter contributes to excellent 5-year survival after relapse (50±8\%). Despite more severe infections and pulmonary toxicities in infants, treatment-related death rate was identical to that of older children (3\%). Our data indicate that intensive frontline and relapse AML treatment is feasible in infants, toxicities are manageable, and outcome is favorable.",

keywords = "acute myeloid leukemia, children, infants, treatment",

author = "U. Creutzig and M. Zimmermann and Bourquin, \{J. P.\} and Dworzak, \{M. N.\} and B. Kremens and T. Lehrnbecher and \{Von Neuhoff\}, C. and A. Sander and \{Von Stackelberg\}, A. and I. Schmid and J. Star{\'y} and D. Steinbach and J. Vormoor and D. Reinhardt",

note = "Funding Information: We thank the colleagues, data managers and technicians of the participating hospitals for their valuable cooperation, Jans-Enno M{\"u}ller for competent data management and Ursula Bernsmann for her help in preparing the manuscript. The studies were supported by the Deutsche Krebshilfe e.V. and partly by grant from the Czech Ministry of Education (MSM0021620813).",

year = "2012",

month = apr,

doi = "10.1038/leu.2011.267",

language = "English",

volume = "26",

pages = "654--661",

journal = "Leukemia",

issn = "0887-6924",

publisher = "Springer Nature",

number = "4",

}

Creutzig, U, Zimmermann, M, Bourquin, JP, Dworzak, MN, Kremens, B, Lehrnbecher, T, Von Neuhoff, C, Sander, A, Von Stackelberg, A, Schmid, I, Starý, J, Steinbach, D, Vormoor, J & Reinhardt, D 2012, 'Favorable outcome in infants with AML after intensive first- and second-line treatment: An AML-BFM study group report', Leukemia, vol. 26, no. 4, pp. 654-661. https://doi.org/10.1038/leu.2011.267

TY - JOUR

T1 - Favorable outcome in infants with AML after intensive first- and second-line treatment

T2 - An AML-BFM study group report

AU - Creutzig, U.

AU - Zimmermann, M.

AU - Bourquin, J. P.

AU - Dworzak, M. N.

AU - Kremens, B.

AU - Lehrnbecher, T.

AU - Von Neuhoff, C.

AU - Sander, A.

AU - Von Stackelberg, A.

AU - Schmid, I.

AU - Starý, J.

AU - Steinbach, D.

AU - Vormoor, J.

AU - Reinhardt, D.

N1 - Funding Information: We thank the colleagues, data managers and technicians of the participating hospitals for their valuable cooperation, Jans-Enno Müller for competent data management and Ursula Bernsmann for her help in preparing the manuscript. The studies were supported by the Deutsche Krebshilfe e.V. and partly by grant from the Czech Ministry of Education (MSM0021620813).

PY - 2012/4

Y1 - 2012/4

N2 - Infants <1 year of age have a high prevalence of prognostically unfavorable leukemias and a presumed susceptibility to treatment-related toxicities. A total of 125 infants with acute myeloid leukemia (AML) were treated in studies AML-BFM-98 (n=59) and -2004 (n=66). Treatment regimens of both studies were comparable, consisting of intensive induction followed by four courses (mainly high-dose cytarabine and anthracyclines). Allogeneic- hematopoietic stem-cell-transplantation (allo-HSCT) in 1st remission was optional for high-risk (HR) patients. Most infants (120/125=96%) were HR patients according to morphological, cytogenetic/molecular genetic and response criteria. Five-year overall survival was 66±4%, and improved from 61±6% in study-98 to 75±6% in study-2004 (Plogrank 0.14) and event-free survival rates were 44±6% and 51±6% (P logrank 0.66), respectively. Results in HR infants were similar to those of older HR children (1-<2- or 2-<10-year olds, Plogrank 0.90 for survival). Survival rates of HSCT in 1st remission, initial partial response and after relapse were high (13/14, 2/8 and 20/30 patients, respectively). The latter contributes to excellent 5-year survival after relapse (50±8%). Despite more severe infections and pulmonary toxicities in infants, treatment-related death rate was identical to that of older children (3%). Our data indicate that intensive frontline and relapse AML treatment is feasible in infants, toxicities are manageable, and outcome is favorable.

AB - Infants <1 year of age have a high prevalence of prognostically unfavorable leukemias and a presumed susceptibility to treatment-related toxicities. A total of 125 infants with acute myeloid leukemia (AML) were treated in studies AML-BFM-98 (n=59) and -2004 (n=66). Treatment regimens of both studies were comparable, consisting of intensive induction followed by four courses (mainly high-dose cytarabine and anthracyclines). Allogeneic- hematopoietic stem-cell-transplantation (allo-HSCT) in 1st remission was optional for high-risk (HR) patients. Most infants (120/125=96%) were HR patients according to morphological, cytogenetic/molecular genetic and response criteria. Five-year overall survival was 66±4%, and improved from 61±6% in study-98 to 75±6% in study-2004 (Plogrank 0.14) and event-free survival rates were 44±6% and 51±6% (P logrank 0.66), respectively. Results in HR infants were similar to those of older HR children (1-<2- or 2-<10-year olds, Plogrank 0.90 for survival). Survival rates of HSCT in 1st remission, initial partial response and after relapse were high (13/14, 2/8 and 20/30 patients, respectively). The latter contributes to excellent 5-year survival after relapse (50±8%). Despite more severe infections and pulmonary toxicities in infants, treatment-related death rate was identical to that of older children (3%). Our data indicate that intensive frontline and relapse AML treatment is feasible in infants, toxicities are manageable, and outcome is favorable.

KW - acute myeloid leukemia

KW - children

KW - infants

KW - treatment

UR - https://www.scopus.com/pages/publications/84859646588

U2 - 10.1038/leu.2011.267

DO - 10.1038/leu.2011.267

M3 - Article

AN - SCOPUS:84859646588

SN - 0887-6924

VL - 26

SP - 654

EP - 661

JO - Leukemia

JF - Leukemia

IS - 4

ER -

Favorable outcome in infants with AML after intensive first- and second-line treatment: An AML-BFM study group report

Abstract

Keywords

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