Therapy

Acute Myelogenous Leukemia in Childhood: Implications of by Privatdozentin Dr. med. Ursula Creutzig (auth.),

By Privatdozentin Dr. med. Ursula Creutzig (auth.), Privatdozentin Dr. med. Ursula Creutzig, Professor Dr. med. Jörg Ritter, Professor Dr. med. Günther Schellong (eds.)

The result of therapy for adolescence acute myelogenous leukemia (AML) have stronger significantly over the past ten years. This development used to be established through the 2 consecutive multicenter stories, AML-BFM-78 and -83, during which nearly exact prolonged multi drug regimes of che­ motherapy have been administered for 8 weeks and up via years upkeep. the most distinction within the moment research used to be the addition of an eight-day extensive in­ duction direction. because of this new aspect, the relapse price used to be diminished considerably. one other results of the BFM-83 research was once the definition of 2 danger teams at the foundation of standardized remedy, which has bring about a risk-adapted remedy method within the 3rd ongoing trial, AML-BFM- 87. This development used to be in basic terms attainable because of the coop­ eration of pediatricians, physicians, radiotherapists, statisti­ cians, and particularly the workers on the hospitals and reference laboratories. therefore, we wish to thank everybody who has been focused on those reviews and desire that they are going to be additional inspired to enhance therapy ideas for AML in kids. The coordination, enforcement, and analyses of the stud­ ies do not have been attainable with out the monetary sup­ port of the Federal Ministry for learn and know-how of the FRG. we're thankful for the beneficiant contributions helping this e-book from Lederle and Farmitalia. Munster, April 1990 Ursula Creutzig Jorg Ritter Gunther Schellong Contents 1 advent . . . . .. . . . . . . . . . . . . . . .. . . . 1 .

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FAB M5 (acute monocytic leukemia). Characteristic features were low median leukocyte counts (12000/mm 3 and 20000/mm 3) as well as hy- Table8. Morphological subtypes according to the FAB classification in AML-BFM78 and AML-BFM-83 AML-BFM-78 No. 6 40 41 5 32 6 24 31 3 24 0 15 6 19 20 26 15 19 6 26 3 14 3 62 38 68 32 51 49 47 53 20 23 10;5 11;1 20 24 37 83 34 78 M2 9;11 10;6 36 No. 3 20 10 0 0 0 0 40 60 l3;7 2;4 4 6 78 M3 --- Table 9. j:>. Analysis of Pretherapeutic Patient Data 25 perleukocytosis (Fig.

Eosinophils. Quantitative information is available on 74% of the patients in AML-BFM-78 and 86% of the patients in AML-BFM-83. All the following data refer to these patients. In 73 out of 269 patients (27%) in both studies the initial BM smear showed eosinophilia, defined as ~ 3% immature or mature eosinophils. This condition was found most frequently in children with F AB types M2 (28/64 = 44%) and M4 (29170 = 41%). Atypical eosinophils were only detected with ~ 3% of these cells, predominantly in FAB type M4 (20129 = 71%).

07 5 S YERRS CCR CCR CCR CCR H II: 0 ~ Q. 91 9 FRB 1 ......... 9S 5 S YERRS CCR CCR CCR CCR Fig. 13. a Probability of EFS duration in the FAB types MI, M2, M4, and M5 (AMLBFM-83). 09), (Fig. 19). FAB M2. At 30/37 children (81%), the proportion of M2 patients whq entered remission was lower in AML-BFM-83 than in AML-BFM-78 (33/34 patients, 97%) (Fig. 15a); however, few relapses occurred in AML-BFM-83. 08, Fig. 15b). 42 Results >- 1. 8 .... J .... :.................... 0.. 2 2 3 - - AML-BFM 78 ( N ...........

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