Outcome of children with relapsed acute myeloid leukemia following initial therapy under the AML99 protocol

Hideki Nakayama, Ken Tabuchi, Akio Tawa, Ichiro Tsukimoto, Masahiro Tsuchida, Akira Morimoto, Hiromasa Yabe, Keizo Horibe, Ryoji Hanada, Masue Imaizumi, Yasuhide Hayashi, Kazuko Hamamoto, Ryoji Kobayashi, Kazuko Kudo, Akira Shimada, Takako Miyamura, Hiroshi Moritake, Daisuke Tomizawa, Takashi Taga, Souichi Adachi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The outcomes of children with relapsed acute myeloid leukemia (AML) are known to be poor, but remain obscure. We retrospectively analyzed 71 patients who had relapsed following first-line treatment under the AML99 protocol. We investigated the time and site of recurrence, response to re-induction therapy, and performance of hematopoietic stem cell transplantation (HSCT) in relapsed cases, and performed a multivariate analysis to identify prognostic factors. The 5-year overall-survival (OS) rate after relapse was 37 %. Of 71 patients, three died without any anti-leukemic therapy and two underwent allogeneic HSCT. The remaining 66 patients received re-induction chemotherapy, and 33 (50 %) achieved second CR (CR2). Twenty-two of 25 (88 %) late relapse patients and 11 of 41 (27 %) early relapse patients achieved CR2 (P <0.001). Twenty-nine CR2 cases and 35 non-CR2 cases underwent allogeneic HSCT. The 5-year OS rate was significantly higher in patients who underwent HSCT in CR2 than those in non-CR2 (66 vs. 17 %, P <0.000001). Multivariate analysis indicated that early relapse (P <0.05) and the positivity of the FMS-like tyrosine kinase 3-internal tandem duplication (P <0.05) were adverse prognostic factors for survival. In conclusion, the etiology of relapsed pediatric AML needs to be elucidated and effective chemotherapy should be administered to obtain CR2.

Original languageEnglish
Pages (from-to)171-179
Number of pages9
JournalInternational Journal of Hematology
Volume100
Issue number2
DOIs
Publication statusPublished - 2014

Fingerprint

Acute Myeloid Leukemia
Hematopoietic Stem Cell Transplantation
Recurrence
Therapeutics
Multivariate Analysis
Survival Rate
Induction Chemotherapy
Protein-Tyrosine Kinases
Pediatrics
Drug Therapy
Survival

Keywords

  • Acute myeloid leukemia (AML)
  • Children
  • Hematopoietic stem cell transplantation (HSCT)
  • Relapse
  • Second complete remission (CR2)

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

Nakayama, H., Tabuchi, K., Tawa, A., Tsukimoto, I., Tsuchida, M., Morimoto, A., ... Adachi, S. (2014). Outcome of children with relapsed acute myeloid leukemia following initial therapy under the AML99 protocol. International Journal of Hematology, 100(2), 171-179. https://doi.org/10.1007/s12185-014-1616-9

Outcome of children with relapsed acute myeloid leukemia following initial therapy under the AML99 protocol. / Nakayama, Hideki; Tabuchi, Ken; Tawa, Akio; Tsukimoto, Ichiro; Tsuchida, Masahiro; Morimoto, Akira; Yabe, Hiromasa; Horibe, Keizo; Hanada, Ryoji; Imaizumi, Masue; Hayashi, Yasuhide; Hamamoto, Kazuko; Kobayashi, Ryoji; Kudo, Kazuko; Shimada, Akira; Miyamura, Takako; Moritake, Hiroshi; Tomizawa, Daisuke; Taga, Takashi; Adachi, Souichi.

In: International Journal of Hematology, Vol. 100, No. 2, 2014, p. 171-179.

Research output: Contribution to journalArticle

Nakayama, H, Tabuchi, K, Tawa, A, Tsukimoto, I, Tsuchida, M, Morimoto, A, Yabe, H, Horibe, K, Hanada, R, Imaizumi, M, Hayashi, Y, Hamamoto, K, Kobayashi, R, Kudo, K, Shimada, A, Miyamura, T, Moritake, H, Tomizawa, D, Taga, T & Adachi, S 2014, 'Outcome of children with relapsed acute myeloid leukemia following initial therapy under the AML99 protocol', International Journal of Hematology, vol. 100, no. 2, pp. 171-179. https://doi.org/10.1007/s12185-014-1616-9
Nakayama, Hideki ; Tabuchi, Ken ; Tawa, Akio ; Tsukimoto, Ichiro ; Tsuchida, Masahiro ; Morimoto, Akira ; Yabe, Hiromasa ; Horibe, Keizo ; Hanada, Ryoji ; Imaizumi, Masue ; Hayashi, Yasuhide ; Hamamoto, Kazuko ; Kobayashi, Ryoji ; Kudo, Kazuko ; Shimada, Akira ; Miyamura, Takako ; Moritake, Hiroshi ; Tomizawa, Daisuke ; Taga, Takashi ; Adachi, Souichi. / Outcome of children with relapsed acute myeloid leukemia following initial therapy under the AML99 protocol. In: International Journal of Hematology. 2014 ; Vol. 100, No. 2. pp. 171-179.
@article{c827748724464ab1b1b81657d189d71d,
title = "Outcome of children with relapsed acute myeloid leukemia following initial therapy under the AML99 protocol",
abstract = "The outcomes of children with relapsed acute myeloid leukemia (AML) are known to be poor, but remain obscure. We retrospectively analyzed 71 patients who had relapsed following first-line treatment under the AML99 protocol. We investigated the time and site of recurrence, response to re-induction therapy, and performance of hematopoietic stem cell transplantation (HSCT) in relapsed cases, and performed a multivariate analysis to identify prognostic factors. The 5-year overall-survival (OS) rate after relapse was 37 {\%}. Of 71 patients, three died without any anti-leukemic therapy and two underwent allogeneic HSCT. The remaining 66 patients received re-induction chemotherapy, and 33 (50 {\%}) achieved second CR (CR2). Twenty-two of 25 (88 {\%}) late relapse patients and 11 of 41 (27 {\%}) early relapse patients achieved CR2 (P <0.001). Twenty-nine CR2 cases and 35 non-CR2 cases underwent allogeneic HSCT. The 5-year OS rate was significantly higher in patients who underwent HSCT in CR2 than those in non-CR2 (66 vs. 17 {\%}, P <0.000001). Multivariate analysis indicated that early relapse (P <0.05) and the positivity of the FMS-like tyrosine kinase 3-internal tandem duplication (P <0.05) were adverse prognostic factors for survival. In conclusion, the etiology of relapsed pediatric AML needs to be elucidated and effective chemotherapy should be administered to obtain CR2.",
keywords = "Acute myeloid leukemia (AML), Children, Hematopoietic stem cell transplantation (HSCT), Relapse, Second complete remission (CR2)",
author = "Hideki Nakayama and Ken Tabuchi and Akio Tawa and Ichiro Tsukimoto and Masahiro Tsuchida and Akira Morimoto and Hiromasa Yabe and Keizo Horibe and Ryoji Hanada and Masue Imaizumi and Yasuhide Hayashi and Kazuko Hamamoto and Ryoji Kobayashi and Kazuko Kudo and Akira Shimada and Takako Miyamura and Hiroshi Moritake and Daisuke Tomizawa and Takashi Taga and Souichi Adachi",
year = "2014",
doi = "10.1007/s12185-014-1616-9",
language = "English",
volume = "100",
pages = "171--179",
journal = "International Journal of Hematology",
issn = "0925-5710",
publisher = "Springer Japan",
number = "2",

}

TY - JOUR

T1 - Outcome of children with relapsed acute myeloid leukemia following initial therapy under the AML99 protocol

AU - Nakayama, Hideki

AU - Tabuchi, Ken

AU - Tawa, Akio

AU - Tsukimoto, Ichiro

AU - Tsuchida, Masahiro

AU - Morimoto, Akira

AU - Yabe, Hiromasa

AU - Horibe, Keizo

AU - Hanada, Ryoji

AU - Imaizumi, Masue

AU - Hayashi, Yasuhide

AU - Hamamoto, Kazuko

AU - Kobayashi, Ryoji

AU - Kudo, Kazuko

AU - Shimada, Akira

AU - Miyamura, Takako

AU - Moritake, Hiroshi

AU - Tomizawa, Daisuke

AU - Taga, Takashi

AU - Adachi, Souichi

PY - 2014

Y1 - 2014

N2 - The outcomes of children with relapsed acute myeloid leukemia (AML) are known to be poor, but remain obscure. We retrospectively analyzed 71 patients who had relapsed following first-line treatment under the AML99 protocol. We investigated the time and site of recurrence, response to re-induction therapy, and performance of hematopoietic stem cell transplantation (HSCT) in relapsed cases, and performed a multivariate analysis to identify prognostic factors. The 5-year overall-survival (OS) rate after relapse was 37 %. Of 71 patients, three died without any anti-leukemic therapy and two underwent allogeneic HSCT. The remaining 66 patients received re-induction chemotherapy, and 33 (50 %) achieved second CR (CR2). Twenty-two of 25 (88 %) late relapse patients and 11 of 41 (27 %) early relapse patients achieved CR2 (P <0.001). Twenty-nine CR2 cases and 35 non-CR2 cases underwent allogeneic HSCT. The 5-year OS rate was significantly higher in patients who underwent HSCT in CR2 than those in non-CR2 (66 vs. 17 %, P <0.000001). Multivariate analysis indicated that early relapse (P <0.05) and the positivity of the FMS-like tyrosine kinase 3-internal tandem duplication (P <0.05) were adverse prognostic factors for survival. In conclusion, the etiology of relapsed pediatric AML needs to be elucidated and effective chemotherapy should be administered to obtain CR2.

AB - The outcomes of children with relapsed acute myeloid leukemia (AML) are known to be poor, but remain obscure. We retrospectively analyzed 71 patients who had relapsed following first-line treatment under the AML99 protocol. We investigated the time and site of recurrence, response to re-induction therapy, and performance of hematopoietic stem cell transplantation (HSCT) in relapsed cases, and performed a multivariate analysis to identify prognostic factors. The 5-year overall-survival (OS) rate after relapse was 37 %. Of 71 patients, three died without any anti-leukemic therapy and two underwent allogeneic HSCT. The remaining 66 patients received re-induction chemotherapy, and 33 (50 %) achieved second CR (CR2). Twenty-two of 25 (88 %) late relapse patients and 11 of 41 (27 %) early relapse patients achieved CR2 (P <0.001). Twenty-nine CR2 cases and 35 non-CR2 cases underwent allogeneic HSCT. The 5-year OS rate was significantly higher in patients who underwent HSCT in CR2 than those in non-CR2 (66 vs. 17 %, P <0.000001). Multivariate analysis indicated that early relapse (P <0.05) and the positivity of the FMS-like tyrosine kinase 3-internal tandem duplication (P <0.05) were adverse prognostic factors for survival. In conclusion, the etiology of relapsed pediatric AML needs to be elucidated and effective chemotherapy should be administered to obtain CR2.

KW - Acute myeloid leukemia (AML)

KW - Children

KW - Hematopoietic stem cell transplantation (HSCT)

KW - Relapse

KW - Second complete remission (CR2)

UR - http://www.scopus.com/inward/record.url?scp=84905901486&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905901486&partnerID=8YFLogxK

U2 - 10.1007/s12185-014-1616-9

DO - 10.1007/s12185-014-1616-9

M3 - Article

C2 - 24961644

AN - SCOPUS:84905901486

VL - 100

SP - 171

EP - 179

JO - International Journal of Hematology

JF - International Journal of Hematology

SN - 0925-5710

IS - 2

ER -