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Treatment and long-term results in children with acute myeloid leukaemia treated according to the AIEOP AML protocols

Abstract

Since 1982, four consecutive studies on childhood acute myeloid leukaemia (AML) (namely LAM-82, -87, -87M and -92) have been conducted in Italy by the Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP) group. The induction therapy of the first three studies consisted of daunorubicin and cytarabine structured in a 3+7 backbone. In the most recent protocol (LAM92), patients received two induction courses including idarubicin, cytarabine and etoposide. Patients with acute promyelocytic leukaemia (20% of diagnoses) were included in LAM-87 and 87M studies. Postremissional therapy significantly changed over time, with an ever-increasing role given to stem cell transplantation (SCT). The long-term outcome of patients enrolled in the LAM-82, 87 and 87M studies was comparable, whereas that of children treated according to LAM-92 study was significantly better (P<0.005). Either allogeneic or autologous SCT was employed as consolidation therapy in more than 75% of cases enrolled in this latter study. Patients enrolled in the LAM-92 study were stratified in standard and high-risk groups with different outcome (67 vs 47%, respectively, P=0.04). Altogether, the results obtained in these four studies have permitted a progressive refinement of treatment, contributing to the structure of the ongoing LAM-2002 protocol that stratifies patients according to the presence of definite genetic anomalies and response to induction therapy.

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Acknowledgements

Until 2000, the coordinator of the AIEOP studies was professor Franco Mandelli, whom we thank for his valuable contribution to the improvement of results in childhood AML in Italy. We are indebted also with Dr Laura Sainati and Dr Emanuela Frascella who performed most of the cytogenetic and molecular biology evaluation on centralised marrow/blood samples.

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Pession, A., Rondelli, R., Basso, G. et al. Treatment and long-term results in children with acute myeloid leukaemia treated according to the AIEOP AML protocols. Leukemia 19, 2043–2053 (2005). https://doi.org/10.1038/sj.leu.2403869

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