Results of Chemotherapy with BFM-87 Protocol in Children with Acute Myeloid Leukemia at a Referral Center in the Southwest of Iran: Clinical Characteristics and Outcome

Mohammad  Pedram; AA Hiradfar

International Journal of Cancer Management

The Official Journal of Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences

Results of Chemotherapy with BFM-87 Protocol in Children with Acute Myeloid Leukemia at a Referral Center in the Southwest of Iran: Clinical Characteristics and Outcome

Author(s):

Mohammad Pedram^1,*,

AA Hiradfar²

1Pediatric oncologist, Shafa hospital, Research Center of Thalassemia and Hemoglobinopathy, Ahwaz Jondishapoor Medical University, Iran

2Pediatric hematology and oncology fellowship, Shafa hospital, Ahwaz Jondishapoor Medical University, Iran

International Journal of Cancer Management:Vol. 2, issue 3; e80573

Published online:Sep 30, 2009

Article type:Research Article

Received:Sep 30, 2009

Accepted:Sep 30, 2009

How to Cite:Mohammad PedramAA HiradfarResults of Chemotherapy with BFM-87 Protocol in Children with Acute Myeloid Leukemia at a Referral Center in the Southwest of Iran: Clinical Characteristics and Outcome.Int J Cancer Manag.2(3):e80573.

Abstract

Introduction: Leukemia is the most common malignancy in childhood, and acute myeloid leukemia (AML) is the second most common leukemia. AML still accounts for more than 30% of deaths from leukemia. AML is classified into several subgroups from M0 to M7 with different presentations, clinical features, and outcomes.

Material and Methods: Between March 1996 and October 2003, 47 children with acute myeloid leukemia were treated with intensive chemotherapy using BFM-87 protocol after remission at Shafa hospital, Ahwaz, Iran. We compared the presenting features and outcomes of therapy in these children based on age, initial White Blood Cells (WBC) count, Central Nervous System involvement, FAB system types, and response to first induction treatment.

Results: Younger children were more likely to have favourable risks and less likely to have induction deaths (p=0.03) and lower relapse risks (p=0.001). FAB types M2 and M4 showed a better first remission rate (p=0.01, p=0.02, respectively), regardless of age and gender. Two major risk factors for relapse after first remission were initial high WBC counts (p=0.01) and older age at the time of diagnosis (p=0.02). Overall survival (p=0.001), event-free survival (p=0.001), and disease-free survival were better (p<0.001) in younger children due to lower relapse rates (p=0.001). Discussion: Overall survival was 53% in the children with new AML who were on intensive chemotherapy with a median follow-up time of 5 years in our study. Relapse risk after first remission for the children who were on intensive chemotherapy alone was 34% in our study.

Conclusion: Because of the potential morbidity and mortality usually related to allogeneic HSCT and also problems due to lack of sufficient HSCT possibility for some patients, several cooperative group trials now do not recommend HSCT for good- or standard- risk patients in their first remission. Results of our study were compatible with BFM , AML 10 and AML 12 groups trials in terms of overall survival, or relapse risk, or induction death risk factors

Keywords

myeloid leukemia

survival

chemotherapy

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