Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG)

Jolanta Skalska-Sadowska; Jacek Wachowiak; Olga Zając-Spychała; Izabela Niewiadomska-Wojnałowicz; Danuta Januszkiewicz-Lewandowska; Walentyna Balwierz; Katarzyna Pawińska-Wąsikowska; Jolanta Goździk; Alicja Chybicka; Kinga Potocka; Maryna Krawczuk-Rybak; Katarzyna Muszyńska-Rosłan; Elżbieta Adamkiewicz-Drożyńska; Lucyna Maciejka-Kapuścińska; Grażyna Karolczyk; Jerzy Kowalczyk; Beata Wójcik; Wanda Badowska; Tomasz Urasiński; Tomasz Ociepa; Michał Matysiak; Barbara Sikorska-Fic; Tomasz Szczepański; Renata Tomaszewska; Grażyna Sobol; Maria Wieczorek; Irena Karpińska-Derda

doi:10.5114/wo.2014.40436

eISSN: 1897-4309
ISSN: 1428-2526

Contemporary Oncology/Współczesna Onkologia

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Original paper

Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG)

Jolanta Skalska-Sadowska

,

Jacek Wachowiak

,

Olga Zając-Spychała

,

Izabela Niewiadomska-Wojnałowicz

,

Danuta Januszkiewicz-Lewandowska

,

Walentyna Balwierz

,

Katarzyna Pawińska-Wąsikowska

,

Jolanta Goździk

,

Alicja Chybicka

,

Kinga Potocka

,

Maryna Krawczuk-Rybak

,

Katarzyna Muszyńska-Rosłan

,

Elżbieta Adamkiewicz-Drożyńska

,

Lucyna Maciejka-Kapuścińska

,

Grażyna Karolczyk

,

Jerzy Kowalczyk

,

Beata Wójcik

,

Wanda Badowska

,

Tomasz Urasiński

,

Tomasz Ociepa

,

Michał Matysiak

,

Barbara Sikorska-Fic

,

Tomasz Szczepański

,

Renata Tomaszewska

,

Grażyna Sobol

,

Maria Wieczorek

,

Irena Karpińska-Derda

Contemp Oncol (Pozn) 2014; 18 (1): 48–53

DOI: https://doi.org/10.5114/wo.2014.40436

Online publish date: 2014/02/28

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AMA

Skalska-Sadowska J, Wachowiak J, Zając-Spychała O, et al. Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG). Contemporary Oncology/Współczesna Onkologia. 2014;18(1):48-53. doi:10.5114/wo.2014.40436.

APA

Skalska-Sadowska, J., Wachowiak, J., Zając-Spychała, O., Niewiadomska-Wojnałowicz, I., Januszkiewicz-Lewandowska, D.,  & Balwierz, W. et al. (2014). Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG). Contemporary Oncology/Współczesna Onkologia, 18(1), 48-53. https://doi.org/10.5114/wo.2014.40436

Chicago

Skalska-Sadowska, Jolanta, Jacek Wachowiak, Olga Zając-Spychała, Izabela Niewiadomska-Wojnałowicz, Danuta Januszkiewicz-Lewandowska, Walentyna Balwierz,  and Katarzyna Pawińska-Wąsikowska et al. 2014. "Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG)". Contemporary Oncology/Współczesna Onkologia 18 (1): 48-53. doi:10.5114/wo.2014.40436.

Harvard

Skalska-Sadowska, J., Wachowiak, J., Zając-Spychała, O., Niewiadomska-Wojnałowicz, I., Januszkiewicz-Lewandowska, D., Balwierz, W., Pawińska-Wąsikowska, K., Goździk, J., Chybicka, A., Potocka, K., Krawczuk-Rybak, M., Muszyńska-Rosłan, K., Adamkiewicz-Drożyńska, E., Maciejka-Kapuścińska, L., Karolczyk, G., Kowalczyk, J., Wójcik, B., Badowska, W., Urasiński, T., Ociepa, T., Matysiak, M., Sikorska-Fic, B., Szczepański, T., Tomaszewska, R., Sobol, G., Wieczorek, M.,  and Karpińska-Derda, I. (2014). Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG). Contemporary Oncology/Współczesna Onkologia, 18(1), pp.48-53. https://doi.org/10.5114/wo.2014.40436

MLA

Skalska-Sadowska, Jolanta et al. "Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG)." Contemporary Oncology/Współczesna Onkologia, vol. 18, no. 1, 2014, pp. 48-53. doi:10.5114/wo.2014.40436.

Vancouver

Skalska-Sadowska J, Wachowiak J, Zając-Spychała O, Niewiadomska-Wojnałowicz I, Januszkiewicz-Lewandowska D, Balwierz W et al. Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG). Contemporary Oncology/Współczesna Onkologia. 2014;18(1):48-53. doi:10.5114/wo.2014.40436.

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Aim of the study: Recent studies showed relatively better outcome for children with refractory (refAML) and relapsed acute myeloid leukemia (relAML). Treatment of these patients has not been unified within Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG) so far. The goal of this study is to analyze the results of this therapy performed between 2005–2011.

Material and methods: The outcome data of 16 patients with refAML and 62 with relAML were analyzed retrospectively. Reinduction was usually based on idarubicine, fludarabine and cytarabine with allogenic hematopoietic stem cell transplant (alloHSCT) in 5 refAML and 30 relAML children.

Results: Seventy seven percent relAML patients entered second complete remission (CR2). Five-year OS and disease-free survival (DFS) were estimated at 16% and 30%. The outcome for patients after alloHSCT in CR2 (63%) was better than that of those not transplanted (36%) with 5-year OS of 34% vs. 2-year of 7% and 5-year DFS of 40% vs. 12.5%. Second complete remission achievement and alloHSCT were the most significant predictors of better prognosis (p = 0.000 and p = 0.024). The outcome of refAML children was significantly worse than relAML with first remission (CR1) rate of 33%, OS and DFS of 25% at 3 years and 53% at 2 years, respectively. All survivors of refAML were treated with alloHSCT after CR1.

Conclusions: The uniform reinduction regimen of the documented efficacy and subsequent alloHSCT in remission is needed to improve the outcome for ref/relAML children treated within PPLLSG. The focus should be on the future risk-directed both front and second line AML therapy.

keywords:

Outcome of refractory and relapsed acute myeloid leukemia in children treated during 2005-2011 – experience of the Polish Pediatric Leukemia/Lymphoma Study Group (PPLLSG)

acute myeloid leukemia, relapse, stem cell transplantation, children