PMID- 28556917
OWN - NLM
STAT- MEDLINE
DCOM- 20170927
LR  - 20191210
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Print)
IS  - 0008-543X (Linking)
VI  - 123
IP  - 19
DP  - 2017 Oct 1
TI  - Decreased relapsed rate and treatment-related mortality contribute to improved 
      outcomes for pediatric acute myeloid leukemia in successive clinical trials.
PG  - 3791-3798
LID - 10.1002/cncr.30791 [doi]
AB  - BACKGROUND: Outcomes for children with acute myeloid leukemia (AML) have improved 
      over the past 20 years even though the medications used for induction therapy 
      have not changed. METHODS: This study analyzed data from patients with AML who 
      were enrolled in successive protocols (AML97 and AML02) to determine the 
      contributors to the improved outcomes of the latter clinical trial. RESULTS: 
      There were significant improvements in 5-year overall survival (48.9% vs 71.2%; 
      P < .0001) and event-free survival (43.5% vs 61.8%; P = .002) from AML97 to 
      AML02. The 5-year cumulative incidence of early death (ED)/treatment-related 
      mortality (TRM) was reduced for patients treated in AML02 (18.5% vs 7.9%; 
      P = .007). Although the overall incidence of refractory disease (6.5% vs 5.6%; 
      P = .736) and relapse (29.3% vs 21.0%; P = .12) did not differ between the 2 
      studies, patients with low-risk AML who were treated in AML02 had a reduced 
      incidence of relapse (27.3% vs 8.8%; P = .036). CONCLUSIONS: The improved 
      outcomes of the AML02 trial resulted from improved disease control for low-risk 
      patients and overall decreased ED/TRM. These results emphasize the importance of 
      supportive-care measures throughout chemotherapy courses and hematopoietic cell 
      transplantation and the value of treatment intensity for patients with low-risk 
      AML while underscoring the need for novel therapy, rather than increased therapy 
      intensity, for children with high-risk AML. Cancer 2017;123:3791-3798. (c) 2017 
      American Cancer Society.
CI  - (c) 2017 American Cancer Society.
FAU - Alexander, Thomas B
AU  - Alexander TB
AUID- ORCID: 0000-0002-0484-1574
AD  - Department of Oncology, St. Jude Children's Research Hospital, Memphis, 
      Tennessee.
AD  - Department of Pediatrics, University of North Carolina, Chapel Hill, North 
      Carolina.
FAU - Wang, Lei
AU  - Wang L
AD  - Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, 
      Tennessee.
FAU - Inaba, Hiroto
AU  - Inaba H
AD  - Department of Oncology, St. Jude Children's Research Hospital, Memphis, 
      Tennessee.
AD  - Department of Pediatrics, College of Medicine, University of Tennessee Health 
      Science Center, Memphis, Tennessee.
FAU - Triplett, Brandon M
AU  - Triplett BM
AD  - Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude 
      Children's Research Hospital, Memphis, Tennessee.
FAU - Pounds, Stanley
AU  - Pounds S
AUID- ORCID: 0000-0002-9167-2114
AD  - Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, 
      Tennessee.
FAU - Ribeiro, Raul C
AU  - Ribeiro RC
AD  - Department of Oncology, St. Jude Children's Research Hospital, Memphis, 
      Tennessee.
AD  - Department of Pediatrics, College of Medicine, University of Tennessee Health 
      Science Center, Memphis, Tennessee.
FAU - Pui, Ching-Hon
AU  - Pui CH
AD  - Department of Oncology, St. Jude Children's Research Hospital, Memphis, 
      Tennessee.
AD  - Department of Pediatrics, College of Medicine, University of Tennessee Health 
      Science Center, Memphis, Tennessee.
FAU - Rubnitz, Jeffrey E
AU  - Rubnitz JE
AD  - Department of Oncology, St. Jude Children's Research Hospital, Memphis, 
      Tennessee.
AD  - Department of Pediatrics, College of Medicine, University of Tennessee Health 
      Science Center, Memphis, Tennessee.
LA  - eng
GR  - P30 CA021765/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20170530
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
RN  - 0 (Aminoglycosides)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antineoplastic Agents)
RN  - 04079A1RDZ (Cytarabine)
RN  - 47M74X9YT5 (Cladribine)
RN  - 6PLQ3CP4P3 (Etoposide)
RN  - 93NS566KF7 (Gemtuzumab)
RN  - BZ114NVM5P (Mitoxantrone)
RN  - EC 3.5.1.1 (Asparaginase)
RN  - ZS7284E0ZP (Daunorubicin)
SB  - IM
MH  - Adolescent
MH  - Aminoglycosides/administration & dosage
MH  - Antibodies, Monoclonal, Humanized/administration & dosage
MH  - Antineoplastic Agents/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Asparaginase/administration & dosage
MH  - Child
MH  - Child, Preschool
MH  - Cladribine/administration & dosage
MH  - Clinical Protocols
MH  - Consolidation Chemotherapy/methods
MH  - Cytarabine/administration & dosage
MH  - Daunorubicin/administration & dosage
MH  - Disease-Free Survival
MH  - Etoposide/administration & dosage
MH  - Female
MH  - Gemtuzumab
MH  - Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Induction Chemotherapy/*methods
MH  - Infant
MH  - Infant, Newborn
MH  - Leukemia, Myeloid, Acute/*drug therapy/*mortality
MH  - Male
MH  - Mitoxantrone/administration & dosage
MH  - Neoplasm, Residual
MH  - Recurrence
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5610607
MID - NIHMS873562
OTO - NOTNLM
OT  - leukemia
OT  - outcomes
OT  - pediatric
OT  - supportive care
EDAT- 2017/05/31 06:00
MHDA- 2017/09/28 06:00
PMCR- 2018/10/01
CRDT- 2017/05/31 06:00
PHST- 2017/02/02 00:00 [received]
PHST- 2017/04/13 00:00 [revised]
PHST- 2017/04/25 00:00 [accepted]
PHST- 2017/05/31 06:00 [pubmed]
PHST- 2017/09/28 06:00 [medline]
PHST- 2017/05/31 06:00 [entrez]
PHST- 2018/10/01 00:00 [pmc-release]
AID - 10.1002/cncr.30791 [doi]
PST - ppublish
SO  - Cancer. 2017 Oct 1;123(19):3791-3798. doi: 10.1002/cncr.30791. Epub 2017 May 30.