Appropriate dose reduction in induction therapy is essential for the treatment of infants with acute myeloid leukemia: a report from the Japanese Pediatric Leukemia/Lymphoma Study Group.
Appropriate dose reduction in induction therapy is essential for the treatment of infants with acute myeloid leukemia: a report from the Japanese Pediatric Leukemia/Lymphoma Study Group.
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DOI：
10.1007/s12185-013-1429-2
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发表时间：
2013-11
影响因子：
2.1
通讯作者：
Adachi S
中科院分区：
文献类型：
--
作者：
Tomizawa D;Tawa A;Watanabe T;Saito AM;Kudo K;Taga T;Iwamoto S;Shimada A;Terui K;Moritake H;Kinoshita A;Takahashi H;Nakayama H;Kiyokawa N;Isoyama K;Mizutani S;Hara J;Horibe K;Nakahata T;Adachi S
患有急性髓性白血病（AML）的婴儿（<1岁）特别容易受到强化细胞毒性治疗的影响。事实上，在日本儿童白血病/淋巴瘤研究组AML-05研究中，婴儿的死亡率很高，这促使我们暂停患者招募并修改方案。入组了45例AML婴儿。对于年龄<2岁的患者，根据体重调整药物剂量。在方案修订后，婴儿的剂量在初始诱导过程中进一步减少了33%。6名婴儿在诱导阶段死亡（包括5名早期死亡），主要是由于肺部并发症。所有45例婴儿的3年总生存概率（pOS）[55.9%，95%可信区间（CI）37.9- 70.6%]显著低于1 ~<2岁的患者（77.0%，95%CI 62.7- 86.3%）和≥2岁的患者（74.7%，95%CI 69.2- 79.4%）（P = 0.037），主要是由于婴儿的非复发死亡率较高。方案修订后未发生早期死亡，此后入组的17名婴儿的3年pOS为76.4%（95%CI 48.8- 90.4%）。总之，在治疗患有AML的婴儿时，适当的剂量减少对于避免早期死亡至关重要。
Infants (<1 year old) with acute myeloid leukemia (AML) are particularly vulnerable to intensive cytotoxic therapy. Indeed, the mortality rate was high among infants enrolled in the Japanese Pediatric Leukemia/Lymphoma Study Group AML-05 study, which prompted us to temporarily suspend patient enrollment and amend the protocol. Forty-five infants with AML were enrolled. For patients aged <2 years, drug doses were adjusted for body weight. Following the protocol amendments, doses for infants were reduced by a further 33 % in the initial induction course. Six infants died during the induction phase (including five early deaths), mainly due to pulmonary complications. The 3-year probability of overall survival (pOS) in all 45 infants [55.9 %, 95 % confidence interval (CI) 37.9–70.6 %] was significantly lower than that of patients aged 1 to <2 years (77.0 %, 95 % CI 62.7–86.3 %) and those aged ≥2 years (74.7 %, 95 % CI 69.2–79.4 %) (P = 0.037), mainly due to the higher non-relapse mortality rate in infants. No early deaths occurred after the protocol amendments, and the 3-year pOS of the 17 infants enrolled thereafter was 76.4 % (95 % CI 48.8–90.4 %). In conclusion, appropriate dose reduction is essential to avoid early deaths when treating infants with AML.
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影响因子：
51.1
作者：
Rubnitz, Jeffrey E.;Inaba, Hiroto;Dahl, Gary;Ribeiro, Raul C.;Bowman, W. Paul;Taub, Jeffrey;Pounds, Stanley;Razzouk, Bassem I.;Lacayo, Norman J.;Cao, Xueyuan;Meshinchi, Soheil;Degar, Barbara;Airewele, Gladstone;Raimondi, Susana C.;Onciu, Mihaela;Coustan-Smith, Elaine;Downing, James R.;Leung, Wing;Pui, Ching-Hon;Campana, Dario
通讯作者：
Campana, Dario
影响因子：
11.4
作者：
Creutzig, U.;Zimmermann, M.;Reinhardt, D.
通讯作者：
Reinhardt, D.
影响因子：
11.4
作者：
Smith, FO;Alonzo, T;Arceci, R
通讯作者：
Arceci, R
影响因子：
20.3
作者：
Kawasaki, H;Isoyama, K;Ishii, E
通讯作者：
Ishii, E
影响因子：
4.3
作者：
Schmid, Irene;Stachel, Daniel;Albert, Michael H.
通讯作者：
Albert, Michael H.