Treatment and clinical results in childhood AML in Greece
Background: The primary objective of our study is to describe the clinical results of children with AML, treated with BFM protocols, in two institutions in Greece.
Patients and methods: Between January 1997 and December 2011, 84 children with primary and secondary AML were treated with BFM AML 93, 98 and 2004 protocol and were eligible for evaluation.
Results: Median follow-up for survivors was 86.3 months. The most usual cytogenetic abnormalities t(8;21), t(15;17) and Myeloid/Lymphoid (MLL) rearrangement were detected in eight, six, and nine children respectively. Out of the 73 patients with primary AML, three died before completion of first induction. Only one has never responded to chemotherapy and eight patients had M2 or M3 bone marrow after induction and required more than one courses to achieve remission. On the whole, 46/70 (65.7 %) patients are alive, in remission. Out of 24 patients who suffered from relapse, only seven are alive in second remission. The event-free survival in standard and high risk group was 17/21 (80.9 %) and 31/52 (59.6 %), respectively, with the difference being statistically significant.
Conclusions: The major cause of mortality in children with AML in our institutions was recurrence of disease. Supportive care, molecular features of the disease, and response to therapy are increasingly used to optimize treatment for all patients.