Optimal treatment intensity in children with Down syndrome and myeloid leukaemia: data from 56 children treated on NOPHO-AML protocols and a review of the literature

Annals of Hematology
Lotte AbildgaardHenrik Hasle

Abstract

Children with Down syndrome (DS) and myeloid leukaemia have a significantly higher survival rate than other children, but they also experience considerable treatment-related toxicity. We analysed data on 56 children with DS who were treated on the Nordic Society for Paediatric Haematology and Oncology-acute myeloid leukaemia (NOPHO-AML)88 and NOPHO-AML93 protocols and reviewed the literature. In the dose-intensive NOPHO-AML88 protocol, 8 out of 15 patients (53%) experienced an event. In the less dose-intensive NOPHO-AML93 protocol, 7 out of 41 patients (17%) had an event. Therapy was reduced in 29 patients (52%) with in average 75% and 67% of the scheduled dose of anthracycline and cytarabine, respectively. Treatment-related death occurred in seven who all received full treatment. Relapse and resistant disease occurred at a similar rate in those receiving full and reduced treatment. Review of major series of myeloid leukaemia of DS showed no clear relationship between dose and survival; however, it appears that both a reduction in treatment dose and a less intensively timed treatment regimen improved the outcome. Further studies are needed to define the optimal regimen for treating myeloid leukaemia of DS.

References

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Citations

Apr 4, 2009·Anti-cancer Drugs·Josefine PalleUNKNOWN Nordic Society for Paediatric Haematology and Oncology
Jan 17, 2007·Current Opinion in Pediatrics·Henrik Hasle
May 3, 2011·PloS One·Valerio CostaAlfredo Ciccodicola
Jan 30, 2009·The Oncologist·Karen R Rabin, James A Whitlock
Jan 19, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Maureen M O'BrienUNKNOWN Children's Oncology Group Study POG 9421
Sep 28, 2010·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·J L Fuster SolerF Ortuño Giner
Feb 2, 2010·Hematology/oncology Clinics of North America·C Michel ZwaanParesh Vyas
Feb 5, 2008·Pediatric Clinics of North America·Michel C ZwaanParesh Vyas
May 31, 2008·British Journal of Haematology·Hideki MuramatsuSeiji Kojima
Dec 21, 2012·Pediatric Blood & Cancer·Alan S GamisUNKNOWN COG Acute Myeloid Leukemia Committee
Sep 10, 2011·British Journal of Haematology·Brenda E S GibsonUNKNOWN United Kingdom Childhood Leukaemia Working Group and the Dutch Childhood Oncology Group
Dec 5, 2013·Pediatric Blood & Cancer·Hideki MuramatsuKazuko Kudo
Dec 1, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Kazuko KudoUNKNOWN Japanese Childhood AML Cooperative Study Group
Dec 10, 2015·Pediatrics International : Official Journal of the Japan Pediatric Society·Takashi TagaSouichi Adachi
Dec 10, 2016·American Journal of Speech-language Pathology·Laura M JusticeMary Beth Schmitt
Sep 19, 2014·Expert Review of Hematology·J Timothy CaldwellJeffrey W Taub
Jan 26, 2016·Journal of Pediatric Hematology/oncology·Grace Kee See LamChi Kong Li
May 3, 2019·Critical Reviews in Clinical Laboratory Sciences·Valentina SasCiprian Tomuleasa
Feb 26, 2016·Journal of Pediatric Hematology/oncology·Erik Hefti, Javier G Blanco

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