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 early life acute myelogenous leukemia (AML) have more suitable significantly over the past ten years. This development used to be verified by way of the 2 consecutive multicenter reports, AML-BFM-78 and -83, within which virtually 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 learn was once the addition of an eight-day in depth in duction path. because of this new point, the relapse expense used to be diminished considerably. one other results of the BFM-83 research used to be the definition of 2 threat teams at the foundation of standardized remedy, which has bring about a risk-adapted therapy process within the 3rd ongoing trial, AML-BFM- 87. This development used to be in simple terms attainable because of 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 body who has been excited about those experiences and desire that they're going to be additional inspired to enhance therapy concepts for AML in teenagers. The coordination, enforcement, and analyses of the stud ies should not have been attainable with no the monetary sup port of the Federal Ministry for learn and know-how of the FRG. we're thankful for the beneficiant contributions assisting this publication from Lederle and Farmitalia. Munster, April 1990 Ursula Creutzig Jorg Ritter Gunther Schellong Contents 1 advent . . . . .. . . . . . . . . . . . . . . .. . . . 1 .
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Additional resources for Acute Myelogenous Leukemia in Childhood: Implications of Therapy Studies for Future Risk-Adapted Treatment Strategies
I1IB ) L. _ _ _ _ _ _ _ _ ... 1111 p (1-3)-111. BS ) 0 '"n. B B 2 HBC ( 2BBBB HBC 2BBBB -( IBBBBB HBC >- IBBBBB 3 4 N- 75 N- IS N - 49 5 6 YEARS 4S IN CCR 25 IN CCR 8 IN CCR Fig. 25. a Probability of EFI duration by WBC in AML-BFM-78. b Same in AMLBFM-83 Risk Factor Analysis of Pretherapeutic and Response-Kinetic Parameters >- 55 1. J H ~ 0 .. 8 III o a:: Q. :·······.. 11 - - AML-BFM 78 ( N = ........... Jf- .... , a:: Q. •.. AML-BFM 83 3 ( ( NN- 4 62 64 5 6 7 8 9 YEARS 24 IN CCR 33 IN CCR Fig.
O '" '"a. 2 FAB Subtypes Table 8 shows a comparison of FAB subtyping in the two studies. 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).
Extramedullary organ involvement in studies AML-BFM-78 and AMLBFM-83 AML-BFM-78 No. gingiva Lymphoma Intestines Muscular system Pericard Lungs Testes Testes and skin All organs Kidney Bone Orbita AML-BFM-83 8 4 3 1 3 2 4 1 13 7 4 2 2 2 2 1 t 1 1 2 to} ! 3 0 .... Il! 0 n. 0 Il! n. 0+---~--~--~--~~--L---4----L--~6 100 a 1000 TOTAL GROUP 10000 (N = 333 ) 100000 1·10, LEUKOCYTES Fig. 5 a-d. Distribution of leukocyte counts in AML-BFM-78 and AMIFBFM-83. B '"a. 6 :::::1:::1:::::[::-:1 . <~. . . .