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Treatment strategy and results in children treated on three Dutch Childhood Oncology Group acute myeloid leukemia trials

Leukemia volume 19, pages 2063–2071 (2005)Cite this article

Abstract

This report describes the long-term follow-up data of three consecutive Dutch Childhood Oncology Group acute myeloid leukemia (AML) protocols. A total of 303 children were diagnosed with AML, of whom 209 were eligible for this report. The first study was the AML-82 protocol. Results were inferior (5-year probability of overall survival (pOS) 31%) to other available regimes. Study AML-87 was based on the BFM-87 protocol, with prophylactic cranial irradiation in high-risk patients only, and without maintenance therapy. This led to a higher cumulative incidence of relapse than that reported by the Berlin–Frankfurt–Münster (BFM), but survival was similar (5-year pOS 47%), suggesting successful retrieval at relapse. The subsequent study AML-92/94 consisted of a modified BFM-93 protocol, that is, without maintenance therapy and prophylactic cranial irradiation. However, all patients were to be transplanted (auto- or allogeneic), although compliance was poor. Antileukemic efficacy was offset by an increase in the cumulative incidence of nonrelapse mortality, especially in remission patients, and survival did not improve (5-year pOS 44%). Our results demonstrate that outcome in childhood AML is still unsatisfactory, and that further intensification of therapy carries the risk of enhanced toxicity. Our patients are currently included in the MRC AML studies, based on the results of their AML 10 trial.

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Acknowledgements

We thank all physicians and hospitals for participating in the Dutch Childhood Oncology Study Group AML studies, as well as the technicians and staff from the DCOG central laboratory and data management office. Statistical advice and support was given by R Brand (Leiden University Medical Center, Leiden, The Netherlands).

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Authors and Affiliations

  1. Dutch Childhood Oncology Group, Den Haag, The Netherlands

    G Kardos, C M Zwaan, G J L Kaspers, S S N de-Graaf, E S J M de Bont, A Postma, J P M Bökkerink, R S Weening, A van der Does-van den Berg, E R van Wering, C Korbijn & K Hählen

  2. Department of Pediatric Hematology/Oncology, VU University Medical Center, Amsterdam, The Netherlands

    G Kardos, C M Zwaan & G J L Kaspers

  3. Department of Pediatric Hematology/Oncology, Erasmus Medical Center – Sophia Children's Hospital, Rotterdam, The Netherlands

    C M Zwaan & K Hählen

  4. Department of Pediatric Hematology/Oncology, University Medical Center St Radboud, Nijmegen, The Netherlands

    S S N de-Graaf & J P M Bökkerink

  5. Division of Pediatric Oncology/Hematology, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands

    E S J M de Bont & A Postma

  6. Department of Pediatric Hematology/Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands

    R S Weening

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  1. G Kardos
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Correspondence to C M Zwaan.

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Kardos, G., Zwaan, C., Kaspers, G. et al. Treatment strategy and results in children treated on three Dutch Childhood Oncology Group acute myeloid leukemia trials. Leukemia 19, 2063–2071 (2005). https://doi.org/10.1038/sj.leu.2403873

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