Development of treatment and clinical results in childhood acute myeloid leukemias in Hungary

István Szegedi, Zsuzsanna Jakab, Péter Masát, C. Kiss

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Acute myeloid leukemias (AML) comprising approximately 15 % of pediatric leukemias account for 30 % of all leukemic deaths in children worldwide. The 5-year overall survival (OS) rate now reaches 60-65 % in Western Europe, North America, and the developed countries of Australasia due to risk-tailored chemotherapy and vigorous supportive care. According to data of the Childhood Cancer Registry of the Hungarian Pediatric Oncology-Hematology Group (HPOG), 234 children with AML were treated using the AML-IGCI-90, the AML-BFM-93 (1990-2000), and the AML-BFM-98 (2001-2011) protocols in Hungary. Four-year OS of patients was 34.5 % with the IGCI-90 and 47.9 % with the BFM-98 protocol. Mortality in AML is mainly associated with progressive disease; however, 5-15 % of patients die from treatment-related complications. We have retrospectively analyzed in detail the causes of death in a cohort of patients diagnosed between 2001 and 2011. There were 59 of 112 (52.6 %) fatal events registered until December 31, 2011. The main causes of deaths were progressive disease in 28 patients (47.4 %), infection in 21 patients (35.5 %), bleeding in 6 patients (10.4 %). Hematopoietic stem cell transplantation (HSCT) was carried out in 30 patients and there were 12 (12/59; 20.3 %) transplantation-related deaths of that transplantation-related graft-versus-host disease (GVHD) was seen in 3 patients (5.0 %). Second malignancy (a medulloblastoma) in 1 patient (1.7 %) occurred. HPOG follows the advanced diagnostic and treatment methods of the International BFM Study Group (I-BFM-SG). Unfortunately, treatment outcome measures do not reach that of working groups participating in I-BFM-SG AML clinical trials. The key for improving cure rates in Hungary is to decrease treatment-related mortality (TRM) by applying more vigorous supportive care for children with AML preferably within the frames of clinical studies.

Original languageEnglish
Pages (from-to)69-72
Number of pages4
JournalMemo - Magazine of European Medical Oncology
Volume6
Issue number1
DOIs
Publication statusPublished - Feb 2013

Fingerprint

Hungary
Acute Myeloid Leukemia
Therapeutics
Hematology
Pediatrics
Cause of Death
Transplantation
Australasia
Medulloblastoma
Second Primary Neoplasms
Mortality
Hematopoietic Stem Cell Transplantation
Graft vs Host Disease
Child Care
North America
Developed Countries
Registries
Leukemia
Survival Rate
Outcome Assessment (Health Care)

Keywords

  • Acute myeloid leukemia
  • Hungarian Pediatric Hematology-Oncology Group
  • Results
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Development of treatment and clinical results in childhood acute myeloid leukemias in Hungary. / Szegedi, István; Jakab, Zsuzsanna; Masát, Péter; Kiss, C.

In: Memo - Magazine of European Medical Oncology, Vol. 6, No. 1, 02.2013, p. 69-72.

Research output: Contribution to journalArticle

@article{d4f2a4684cb2484d97289cc7b8d9bd05,
title = "Development of treatment and clinical results in childhood acute myeloid leukemias in Hungary",
abstract = "Acute myeloid leukemias (AML) comprising approximately 15 {\%} of pediatric leukemias account for 30 {\%} of all leukemic deaths in children worldwide. The 5-year overall survival (OS) rate now reaches 60-65 {\%} in Western Europe, North America, and the developed countries of Australasia due to risk-tailored chemotherapy and vigorous supportive care. According to data of the Childhood Cancer Registry of the Hungarian Pediatric Oncology-Hematology Group (HPOG), 234 children with AML were treated using the AML-IGCI-90, the AML-BFM-93 (1990-2000), and the AML-BFM-98 (2001-2011) protocols in Hungary. Four-year OS of patients was 34.5 {\%} with the IGCI-90 and 47.9 {\%} with the BFM-98 protocol. Mortality in AML is mainly associated with progressive disease; however, 5-15 {\%} of patients die from treatment-related complications. We have retrospectively analyzed in detail the causes of death in a cohort of patients diagnosed between 2001 and 2011. There were 59 of 112 (52.6 {\%}) fatal events registered until December 31, 2011. The main causes of deaths were progressive disease in 28 patients (47.4 {\%}), infection in 21 patients (35.5 {\%}), bleeding in 6 patients (10.4 {\%}). Hematopoietic stem cell transplantation (HSCT) was carried out in 30 patients and there were 12 (12/59; 20.3 {\%}) transplantation-related deaths of that transplantation-related graft-versus-host disease (GVHD) was seen in 3 patients (5.0 {\%}). Second malignancy (a medulloblastoma) in 1 patient (1.7 {\%}) occurred. HPOG follows the advanced diagnostic and treatment methods of the International BFM Study Group (I-BFM-SG). Unfortunately, treatment outcome measures do not reach that of working groups participating in I-BFM-SG AML clinical trials. The key for improving cure rates in Hungary is to decrease treatment-related mortality (TRM) by applying more vigorous supportive care for children with AML preferably within the frames of clinical studies.",
keywords = "Acute myeloid leukemia, Hungarian Pediatric Hematology-Oncology Group, Results, Treatment",
author = "Istv{\'a}n Szegedi and Zsuzsanna Jakab and P{\'e}ter Mas{\'a}t and C. Kiss",
year = "2013",
month = "2",
doi = "10.1007/s12254-012-0054-8",
language = "English",
volume = "6",
pages = "69--72",
journal = "Memo - Magazine of European Medical Oncology",
issn = "1865-5041",
publisher = "Springer Wien",
number = "1",

}

TY - JOUR

T1 - Development of treatment and clinical results in childhood acute myeloid leukemias in Hungary

AU - Szegedi, István

AU - Jakab, Zsuzsanna

AU - Masát, Péter

AU - Kiss, C.

PY - 2013/2

Y1 - 2013/2

N2 - Acute myeloid leukemias (AML) comprising approximately 15 % of pediatric leukemias account for 30 % of all leukemic deaths in children worldwide. The 5-year overall survival (OS) rate now reaches 60-65 % in Western Europe, North America, and the developed countries of Australasia due to risk-tailored chemotherapy and vigorous supportive care. According to data of the Childhood Cancer Registry of the Hungarian Pediatric Oncology-Hematology Group (HPOG), 234 children with AML were treated using the AML-IGCI-90, the AML-BFM-93 (1990-2000), and the AML-BFM-98 (2001-2011) protocols in Hungary. Four-year OS of patients was 34.5 % with the IGCI-90 and 47.9 % with the BFM-98 protocol. Mortality in AML is mainly associated with progressive disease; however, 5-15 % of patients die from treatment-related complications. We have retrospectively analyzed in detail the causes of death in a cohort of patients diagnosed between 2001 and 2011. There were 59 of 112 (52.6 %) fatal events registered until December 31, 2011. The main causes of deaths were progressive disease in 28 patients (47.4 %), infection in 21 patients (35.5 %), bleeding in 6 patients (10.4 %). Hematopoietic stem cell transplantation (HSCT) was carried out in 30 patients and there were 12 (12/59; 20.3 %) transplantation-related deaths of that transplantation-related graft-versus-host disease (GVHD) was seen in 3 patients (5.0 %). Second malignancy (a medulloblastoma) in 1 patient (1.7 %) occurred. HPOG follows the advanced diagnostic and treatment methods of the International BFM Study Group (I-BFM-SG). Unfortunately, treatment outcome measures do not reach that of working groups participating in I-BFM-SG AML clinical trials. The key for improving cure rates in Hungary is to decrease treatment-related mortality (TRM) by applying more vigorous supportive care for children with AML preferably within the frames of clinical studies.

AB - Acute myeloid leukemias (AML) comprising approximately 15 % of pediatric leukemias account for 30 % of all leukemic deaths in children worldwide. The 5-year overall survival (OS) rate now reaches 60-65 % in Western Europe, North America, and the developed countries of Australasia due to risk-tailored chemotherapy and vigorous supportive care. According to data of the Childhood Cancer Registry of the Hungarian Pediatric Oncology-Hematology Group (HPOG), 234 children with AML were treated using the AML-IGCI-90, the AML-BFM-93 (1990-2000), and the AML-BFM-98 (2001-2011) protocols in Hungary. Four-year OS of patients was 34.5 % with the IGCI-90 and 47.9 % with the BFM-98 protocol. Mortality in AML is mainly associated with progressive disease; however, 5-15 % of patients die from treatment-related complications. We have retrospectively analyzed in detail the causes of death in a cohort of patients diagnosed between 2001 and 2011. There were 59 of 112 (52.6 %) fatal events registered until December 31, 2011. The main causes of deaths were progressive disease in 28 patients (47.4 %), infection in 21 patients (35.5 %), bleeding in 6 patients (10.4 %). Hematopoietic stem cell transplantation (HSCT) was carried out in 30 patients and there were 12 (12/59; 20.3 %) transplantation-related deaths of that transplantation-related graft-versus-host disease (GVHD) was seen in 3 patients (5.0 %). Second malignancy (a medulloblastoma) in 1 patient (1.7 %) occurred. HPOG follows the advanced diagnostic and treatment methods of the International BFM Study Group (I-BFM-SG). Unfortunately, treatment outcome measures do not reach that of working groups participating in I-BFM-SG AML clinical trials. The key for improving cure rates in Hungary is to decrease treatment-related mortality (TRM) by applying more vigorous supportive care for children with AML preferably within the frames of clinical studies.

KW - Acute myeloid leukemia

KW - Hungarian Pediatric Hematology-Oncology Group

KW - Results

KW - Treatment

UR - http://www.scopus.com/inward/record.url?scp=84875829667&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875829667&partnerID=8YFLogxK

U2 - 10.1007/s12254-012-0054-8

DO - 10.1007/s12254-012-0054-8

M3 - Article

VL - 6

SP - 69

EP - 72

JO - Memo - Magazine of European Medical Oncology

JF - Memo - Magazine of European Medical Oncology

SN - 1865-5041

IS - 1

ER -