Felice Maria S, Rossi Jorge G, Alonso Cristina N, Gallego Marta S, Eberle Silvia Eandi, Alfaro Elizabeth M, Guitter Myriam R, Bernasconi Andrea R, Rubio Patricia L, Coccé Mariela C, Zubizarreta Pedro A
a Hematology and Oncology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
b Immunology-Rheumatology Department , Hospital de Pediatría Prof. Dr. Juan P. Garrahan , Buenos Aires , Argentina ;
Leuk Lymphoma. 2016 Sep;57(9):2090-9. doi: 10.3109/10428194.2015.1131277. Epub 2016 Jan 6.
Childhood acute myeloid leukemia (AML) achieves event-free-survival (EFS) rates of ∼50%. Double induction phase has been introduced for improving these results. Four consecutive protocols for AML treatment were evaluated to assess the impact of the addition of a second induction course in our setting. From January 1990 to January 2014, 307 evaluable AML patients were accrued. They were classified into low-risk (LR) and high-risk (HR) according to cytogenetic/molecular findings and response on day 15. The first two studies administered one induction cycle while the latter two protocols administered double induction. Relapse was the most frequent event and early-deaths were reduced by 50% in the last protocol. Statistically significant differences were observed when comparing EFS in LR and HR groups. Patients from both risk-groups who received double induction achieved significantly better outcome. EFS improved in protocols with double induction and early-deaths rate was decreased. Cytogenetic/molecular features and early-response were confirmed as prognostic factors.
儿童急性髓系白血病（AML）的无事件生存率（EFS）约为50%。为了改善这些结果，引入了双诱导期。对四个连续的AML治疗方案进行了评估，以评估在我们的治疗环境中增加第二个诱导疗程的影响。从1990年1月至2014年1月，共纳入307例可评估的AML患者。根据细胞遗传学/分子学结果以及第15天的反应，将他们分为低风险（LR）和高风险（HR）组。前两项研究采用一个诱导周期，而后两项方案采用双诱导。复发是最常见的事件，在最后一个方案中，早期死亡减少了50%。比较LR组和HR组的EFS时，观察到统计学上的显著差异。接受双诱导的两个风险组患者均取得了显著更好的结果。双诱导方案的EFS有所改善，早期死亡率降低。细胞遗传学/分子学特征和早期反应被确认为预后因素。
