Abstract
Background: On the basis of results of previous Japanese trials for myeloid leukemia in Down syndrome (ML-DS), the efficacy of risk-oriented therapy was evaluated in the Japanese Pediatric Leukemia/Lymphoma Study Group AML-D05 study. Procedure: All patients received induction chemotherapy that consisted of pirarubicin, intermediate-dose cytarabine, and etoposide. Patients who achieved complete remission (CR) after initial induction therapy were stratified to the standard risk (SR) group and received four courses of reduced-dose intensification therapy. Patients who did not achieve CR were stratified to the high risk (HR) group and received intensified therapy that consisted of continuous or high-dose cytarabine. Results: A total of 72 patients were eligible and evaluated. One patient died of sepsis during initial induction therapy. Sixty-nine patients were stratified to SR and two patients to HR. No therapy-related deaths were observed during intensification therapy. The 3-year event-free and overall survival rates were 83.3% ± 4.4% and 87.5% ± 3.9 %, respectively. Age at diagnosis less than 2 years was a significant favorable prognostic factor for risk of relapse (P = 0.009). Conclusions: The attempt of risk-oriented prospective study for ML-DS was unsuccessful, but despite the dose reduction of chemotherapeutic agents, the overall outcome was good, and further dose reduction might be possible for specific subgroups.
| Original language | English |
|---|---|
| Pages (from-to) | 248-254 |
| Number of pages | 7 |
| Journal | Pediatric Blood and Cancer |
| Volume | 63 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 1 2016 |
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Keywords
- acute myeloid leukemia
- clinical trial
- Down syndrome
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Hematology
- Oncology
Cite this
Preserved High Probability of Overall Survival with Significant Reduction of Chemotherapy for Myeloid Leukemia in Down Syndrome : A Nationwide Prospective Study in Japan. / Taga, Takashi; Watanabe, Tomoyuki; Tomizawa, Daisuke; Kudo, Kazuko; Terui, Kiminori; Moritake, Hiroshi; Kinoshita, Akitoshi; Iwamoto, Shotaro; Nakayama, Hideki; Takahashi, Hiroyuki; Shimada, Akira; Taki, Tomohiko; Toki, Tsutomu; Ito, Etsuro; Goto, Hiroaki; Koh, Katsuyoshi; Saito, Akiko M.; Horibe, Keizo; Nakahata, Tatsutoshi; Tawa, Akio; Adachi, Souichi.
In: Pediatric Blood and Cancer, Vol. 63, No. 2, 01.02.2016, p. 248-254.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Preserved High Probability of Overall Survival with Significant Reduction of Chemotherapy for Myeloid Leukemia in Down Syndrome
T2 - A Nationwide Prospective Study in Japan
AU - Taga, Takashi
AU - Watanabe, Tomoyuki
AU - Tomizawa, Daisuke
AU - Kudo, Kazuko
AU - Terui, Kiminori
AU - Moritake, Hiroshi
AU - Kinoshita, Akitoshi
AU - Iwamoto, Shotaro
AU - Nakayama, Hideki
AU - Takahashi, Hiroyuki
AU - Shimada, Akira
AU - Taki, Tomohiko
AU - Toki, Tsutomu
AU - Ito, Etsuro
AU - Goto, Hiroaki
AU - Koh, Katsuyoshi
AU - Saito, Akiko M.
AU - Horibe, Keizo
AU - Nakahata, Tatsutoshi
AU - Tawa, Akio
AU - Adachi, Souichi
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background: On the basis of results of previous Japanese trials for myeloid leukemia in Down syndrome (ML-DS), the efficacy of risk-oriented therapy was evaluated in the Japanese Pediatric Leukemia/Lymphoma Study Group AML-D05 study. Procedure: All patients received induction chemotherapy that consisted of pirarubicin, intermediate-dose cytarabine, and etoposide. Patients who achieved complete remission (CR) after initial induction therapy were stratified to the standard risk (SR) group and received four courses of reduced-dose intensification therapy. Patients who did not achieve CR were stratified to the high risk (HR) group and received intensified therapy that consisted of continuous or high-dose cytarabine. Results: A total of 72 patients were eligible and evaluated. One patient died of sepsis during initial induction therapy. Sixty-nine patients were stratified to SR and two patients to HR. No therapy-related deaths were observed during intensification therapy. The 3-year event-free and overall survival rates were 83.3% ± 4.4% and 87.5% ± 3.9 %, respectively. Age at diagnosis less than 2 years was a significant favorable prognostic factor for risk of relapse (P = 0.009). Conclusions: The attempt of risk-oriented prospective study for ML-DS was unsuccessful, but despite the dose reduction of chemotherapeutic agents, the overall outcome was good, and further dose reduction might be possible for specific subgroups.
AB - Background: On the basis of results of previous Japanese trials for myeloid leukemia in Down syndrome (ML-DS), the efficacy of risk-oriented therapy was evaluated in the Japanese Pediatric Leukemia/Lymphoma Study Group AML-D05 study. Procedure: All patients received induction chemotherapy that consisted of pirarubicin, intermediate-dose cytarabine, and etoposide. Patients who achieved complete remission (CR) after initial induction therapy were stratified to the standard risk (SR) group and received four courses of reduced-dose intensification therapy. Patients who did not achieve CR were stratified to the high risk (HR) group and received intensified therapy that consisted of continuous or high-dose cytarabine. Results: A total of 72 patients were eligible and evaluated. One patient died of sepsis during initial induction therapy. Sixty-nine patients were stratified to SR and two patients to HR. No therapy-related deaths were observed during intensification therapy. The 3-year event-free and overall survival rates were 83.3% ± 4.4% and 87.5% ± 3.9 %, respectively. Age at diagnosis less than 2 years was a significant favorable prognostic factor for risk of relapse (P = 0.009). Conclusions: The attempt of risk-oriented prospective study for ML-DS was unsuccessful, but despite the dose reduction of chemotherapeutic agents, the overall outcome was good, and further dose reduction might be possible for specific subgroups.
KW - acute myeloid leukemia
KW - clinical trial
KW - Down syndrome
UR - http://www.scopus.com/inward/record.url?scp=85006320195&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85006320195&partnerID=8YFLogxK
U2 - 10.1002/pbc.25789
DO - 10.1002/pbc.25789
M3 - Article
VL - 63
SP - 248
EP - 254
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
SN - 1545-5009
IS - 2
ER -