1. ¹Department of Pediatric Oncology/Hematology, Institute of Pediatrics, Medical College Jagiellonian University, Krakow, Poland
2. ²Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical Academy, Gdansk, Poland
3. ³Department of Pediatric Hematology/Oncology, Medical Academy, Wroclaw, Poland
4. ⁴Department of Pediatric Hematology/Oncology, Medical Academy, Lublin, Poland
5. ⁵Department of Pediatrics, Hematology and Oncology, Medical Academy, Warsaw, Poland
6. ⁶Department of Pediatric Hematology/Oncology, Medical Academy, Poznan, Poland
7. ⁷Department of Pediatric Hematology and Chemotherapy, Silesian Medical Academy, Zabrze, Poland
8. ⁸Department of Pediatrics, Hematology and Oncology, Medical Academy, Bydgoszcz, Poland

Correspondence: Dr A Dluzniewska, Department of Pediatric Oncology/Hematology, Polish-American Institute of Pediatrics, Jagiellonian University, Wielicka Str 265, 30-663 Krakow, Poland. Fax: +48 12 6580261; E-mail: balwierz@mp.pl

Received 9 December 2004; Accepted 2 June 2005; Published online 29 September 2005.

Abstract

Until 1983, results of treatment of acute myelogenous leukemia (AML) in Poland with different regimens were very poor. In 1983, the Polish Pediatric Leukemia/Lymphoma Study Group introduced a unified treatment protocol – a modified version of BFM-83 protocol. This led to an increase in the curability of AML from 15% to approximately 32%. In 1994, a modification was made: the high-risk patients (>5% blasts in bone marrow on day 15 of therapy and all M5 cases) received two additional cycles with intermediate-dose cytarabine (ID-ARAC). This led to a nonsignificant improvement in the 5-year event-free survival (EFS) rate from 32 to 36%. A new treatment protocol employing idarubicin in place of daunorubicin was introduced in 1998 and produced better initial responses, increase in the number of patients attaining remission after induction therapy and proportional increase of standard-risk patients.The probability of 5-year EFS (pEFS) for the whole group of patients increased from 36 to 47%. In standard- and high-risk groups, the 5-year pEFS was 62 and 33%, respectively. The probability of 5-year disease-free survival was 58% in the whole group, and there were no differences between risk groups. Unsatisfactory treatment results in children classified into the high-risk group are principally due to the low remission rate.