Superior outcome of infant acute myeloid leukemia with intensive chemotherapy: results of the Japan Infant Leukemia Study Group
Superior outcome of infant acute myeloid leukemia with intensive chemotherapy: results of the Japan Infant Leukemia Study Group
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DOI：
10.1182/blood.v98.13.3589
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发表时间：
2001-12-15
期刊：
影响因子：
20.3
通讯作者：
Ishii, E
中科院分区：
文献类型：
--
作者：
Kawasaki, H;Isoyama, K;Ishii, E
这项研究分析了日本1995年至1998年间接受强化化疗的35名急性髓性白血病（AML）婴儿的数据。法国-美国-英国分类中M4/M5亚型患者（n = 23）发病时男孩、年龄较小（< 6个月）和高白细胞增多症的发生率高于非M4/M5亚型患者（n = 12）。13例（56%）和16例（70%）M4/M5亚型患者也分别出现11q23易位和MLL基因重排，而只有1例非M4/M5亚型患者出现这种重排。所有35例患者均接受由依托泊苷、大剂量阿糖胞苷和蒽环类药物组成的ANLL91方案治疗。所有患者的3年总生存率和无事件生存率（EFS）分别为76%（95%可信区间[Cl]， 61.3%-90.7%）和72% （95% Cl, 56.4%-87.9%）。按年龄、性别、MLL基因重排和发病时白细胞计数划分的两个亚组之间，EFS无显著差异；M4/M5亚型患者的EFS倾向于优于非M4/M5亚型患者。虽然所有6例接受同种异体干细胞移植（SCT）的患者都已完全缓解，但没有证实SCT的益处。这些发现表明，使用ANLL91方案的强化化疗可能是婴儿AML观察到的良好结果的原因，即使没有SCT。MLL基因重排的存在或发病年龄对婴儿AML的预后没有影响。(C) 2001年由美国血液学会出版。
This study analyzed data on 35 infants with acute myeloid leukemia (AML) who were treated with intensive chemotherapy between 1995 and 1998 in Japan. The incidence of boys, younger age (< 6 months old), and hyperleukocytosis at onset was high in patients with the M4/M5 subtype (n = 23) in the French-American-British classification, compared with the non-M4/M5 subtype (n = 12). Thirteen (56%) and 16 (70%) patients with the M4/M5 subtype also showed 11q23 translocations and MLL gene rearrangements, respectively, whereas only one patient with the non-M4/M5 subtype had this rearrangement. All 35 patients were treated with the ANLL91 protocol consisting of etoposide, high-dose cytarabine, and anthracyclines. Overall survival and the event-free survival (EFS) rates at 3 years of all patients were 76% (95% confidence interval [Cl], 61.3%-90.7%) and 72% (95% Cl, 56.4%-87.9%), respectively. EFS showed no significant difference between 2 subgroups divided by age, gender, presence of the MLL gene rearrangements, and white blood cell count at onset; EFS in patients with the M4/M5 subtype tended to be better than those with the non-M4/M5 subtype. Although all 6 patients who underwent allogeneic stem cell transplantation (SCT) have been in complete remission, no benefit of SCT was confirmed. These findings suggest that the intensive chemotherapy with the ANLL91 protocol might have been responsible for the observed good outcome of infant AML, even without SCT. The presence of the MLL gene rearrangements or the age at onset had no impact on the outcome of infant AML. (C) 2001 by The American Society of Hematology.