Treatment of Childhood Acute Myeloid Leukemia in Uruguay: Results of 2 Consecutive Protocols Over 20 Years

• Published in: Journal of pediatric hematology/oncology Vol. 42; no. 5; pp. 359 - 366
• Main Authors: Dufort Y Alvarez, Gustavo, Castiglioni, Mariela, Pagés, Carolina, Incoronato, Andrea, Simon, Elizabeth, Zuccolo, Silvana, Schelotto, Magdalena, Morosini, Fabiana, Amarillo, Paloma, Pereira, Inés, Giordano, Hugo, Dabezies, Agustín, Castillo, Luis
• Format: Journal Article
• Language: English
• Published: United States 01-07-2020
• Subjects: Child; Child, Preschool; Female; Follow-Up Studies; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic Stem Cell Transplantation - mortality; Humans; Infant; Leukemia, Myeloid, Acute - pathology; Leukemia, Myeloid, Acute - therapy; Male; Prognosis; Remission Induction; Retrospective Studies; Siblings; Survival Rate; Tissue Donors - supply & distribution; Transplantation Conditioning; Transplantation, Autologous; Transplantation, Homologous; Uruguay; Uruguay
• ISSN: 1077-4114; 1536-3678
• DOI: 10.1097/MPH.0000000000001751

We evaluated the outcome of 71 children with de novo acute myeloid leukemia enrolled in 2 consecutive protocols in the main pediatric hospital in Uruguay. In the LAM97 protocol (n=34), patients received, as consolidation, autologous or allogeneic hematopoietic stem cell transplantation (HSCT), depending on the availability or not of a matched sibling donor. In the LAM08 protocol (n=37), patients were stratified into risk groups, autologous HSCT was abandoned, and allogeneic HSCT was limited to intermediate-risk patients with matched sibling donor and to all patients who fulfilled the high-risk criteria. Complete remission was achieved in 91% and 92% of patients in LAM97 and LAM08, respectively. Deaths in complete remission were 9.6% and 17.6%, respectively. The incidence of relapse was significantly higher in LAM97, 35.4%, versus 12.5% in LAM08. The 5-year event-free survival and overall survival were 50.0% and 55.9% in LAM97 and 59.9% and 64.8% in LAM08. The 5-year overall survival rates in each of the risk groups were 85.7% and 100% for low risk, 50.0% and 61.2% for intermediate risk, and 42.9% and 50.0% for high risk in LAM97 and LAM08 protocols, respectively. Survival has improved over the last 2 decades, and results are comparable to those published in Europe and North America.