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 remedy for adolescence acute myelogenous leukemia (AML) have superior significantly over the last ten years. This development was once established by way of the 2 consecutive multicenter reviews, AML-BFM-78 and -83, within 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 examine was once the addition of an eight-day in depth in duction path. because of this new aspect, the relapse cost was once diminished considerably. one other results of the BFM-83 examine was once the definition of 2 probability teams at the foundation of standardized therapy, which has bring about a risk-adapted therapy procedure within the 3rd ongoing trial, AML-BFM- 87. This development was once purely attainable due to the coop eration of pediatricians, physicians, radiotherapists, statisti cians, and particularly the workers on the hospitals and reference laboratories. hence, we wish to thank every person who has been excited by those stories and desire that they're going to be additional inspired to enhance therapy thoughts for AML in teenagers. The coordination, enforcement, and analyses of the stud ies do not need been attainable with no the monetary sup port of the Federal Ministry for examine and expertise of the FRG. we're thankful for the beneficiant contributions aiding this booklet from Lederle and Farmitalia. Munster, April 1990 Ursula Creutzig Jorg Ritter Gunther Schellong Contents 1 creation . . . . .. . . . . . . . . . . . . . . .. . . . 1 .
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Additional info for Acute Myelogenous Leukemia in Childhood: Implications of Therapy Studies for Future Risk-Adapted Treatment Strategies
AML-BFM 83 ( N - 139 S2 IN CCR 82 IN CCR Fig. 10. a Probability of EFS duration, study AML-BFM-78 vs. AML-BFM-83. b Probability of EFI duration, study AML-BFM-78 vs. AML-BFM-83 Table 17. Results of BMT in primary nonresponders (NR) or relapse patients AML-BFM-78 AML-BFM-83 Total NR Relapse NR Relapse NR Relapse Death due to complications following BMT Recurrent relapse In CCR 2 2 2 2 2 1 1 3 6 4 1 1 7 Total no. 8 t..... J ..... a: til 0 O! a. 8 t..... J ..... a: til 0 O! a. N N - 4 55. 13 13 2 3 4 - - RELAPSE WITHOUT BMT ( N _........
0 100 d FAB 5 10000 1000 100000 LEUKOCYTES N - 48 Analysis of Pretherapeutic Patient Data 27 sented. However, Fig. 4b clearly shows a steep slope in the curve for children under two with FAB M5. FAR M6 (acute erythroblastic leukemia). This morphological type, seen in only 10 out of 333 patients (3%), is rare. Except for two children who initially showed increased WBe (32000/mm 3 and 40000/mm 3 ), initial pancytopenia was observed. FAR M7 (acute megakaryoblastic leukemia). Morphologic findings of undifferentiated, nongranular blasts with cytoplasmic blebs strongly supported the diagnosis of this subtype in three patients of study AMLBFM-83.
The distribution of subtypes among the study patients differed only in the slightly higher number of patients in AML-BFM-83 with monocytic leukemias (FAB MS) (26% vs. 21%), and the slightly lower number of patients with FAB MI/M2 (40% vs. 47%). The initial clinical and hematological data by FAB subtypes for both studies are described below and listed in Table 9. FAB Ml and M2 (acute myeloblastic leukemia without and with maturation). The initial data showed no relevant differences from those of the total group of AML patients.