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Acute Non-Lymphocytic Leukemias

AML patients with Down syndrome have a high cure rate with AML-BFM therapy with reduced dose intensity

Leukemia volume 19, pages 1355–1360 (2005)Cite this article

Abstract

Despite improved prognosis in acute myelogenous leukaemia (AML) children with Down syndrome (DS), therapy-related toxicity remained a problem. We compared 67 DS patients from study AML-BFM 98 with 51 DS patients of the previous study AML-BFM 93, and the non-DS groups of both studies. Compared to non-DS patients, DS patients were treated with reduced anthracycline doses, without high-dose cytarabine/mitoxantrone and without cranial irradiation. AML-DS patients were in median 1.8 years old, and 102/118 (86%) showed the typical morphology of acute megakaryoblastic leukaemia. In study 93, seven DS patients did not receive AML-specific chemotherapy, and treatment modifications were more common. Results improved significantly for patients treated in study 98 with a 3-year survival of 91±4 vs 70±7% in study 93 (P=0.001). There were no differences in outcome concerning the age groups 0–⩽2 and 2–⩽4 years (event-free survival for treated patients 0–⩽2 years 83±4%, 2–⩽4 years 81±7%). The cumulative incidence of relapses was significantly lower in DS (7±3%) than in non-DS patients (28±7%). Therapy-related toxicity was generally lower in DS patients treated according to study 98. We conclude that a standardised and dose-reduced treatment schedule including the main components of AML treatment is advisable for AML children with DS.

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Authors and Affiliations

  1. Department of Pediatric Hematology and Oncology, University Children's Hospital, Muenster, Germany

    U Creutzig, D Reinhardt & S Diekamp

  2. Children's Cancer Research Institute and St Anna Kinderspital, Vienna, Austria

    M Dworzak

  3. 2nd Medical Faculty Charles University, Prague, Czech Republic

    J Stary

  4. Department of Pediatric Hematology and Oncology, Medical High School, Hanover, Germany

    M Zimmermann

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  1. U Creutzig
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  2. D Reinhardt
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  3. S Diekamp
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  4. M Dworzak
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  5. J Stary
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  6. M Zimmermann
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Correspondence to U Creutzig.

Additional information

This work was supported by the Deutsche Krebshilfe

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Supplementary Information (‘Acknowledgements’) accompanies the paper on the Leukemia website (http://www.nature.com/leu).

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Creutzig, U., Reinhardt, D., Diekamp, S. et al. AML patients with Down syndrome have a high cure rate with AML-BFM therapy with reduced dose intensity. Leukemia 19, 1355–1360 (2005). https://doi.org/10.1038/sj.leu.2403814

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