Long-term results of children with acute myeloid leukemia: A report of three consecutive Phase III trials by the Children's Cancer Group: CCG 251, CCG 213 and CCG 2891

Frank O. Smith, T. A. Alonzo, R. B. Gerbing, W. G. Woods, R. J. Arceci

Research output: Contribution to journalArticlepeer-review

Abstract

The Children's Cancer Group (CCG) conducted three Phase III prospective clinical trials for children with de novo acute myeloid leukemia between the years 1979 and 1995. A total of 1903 eligible children ages birth to 21 years of age were enrolled on CCG 251 (n=485), CCG 213 (n=532) and CCG 2891 (n=886). Follow-up is ongoing, with medians of 7.9, 10.9 and 8.6 years, respectively. These three clinical trials developed dose- and time-intensive induction regimens based upon high-dose cytarabine and daunomycin and randomly assigned patients to allogeneic bone marrow transplantation in first remission if an HLA-matched related donor was identified. Despite dose- and time-intensive induction regimens, remission induction rates remained relatively stable at 77-78%. However, overall survival, event-free survival and disease-free survival (DFS) increased for patients receiving intensive-timing induction therapy in comparison to patients who received standard-timing induction, regardless of the type of postremission therapy. Outcomes were best for patients receiving intensive-timing induction followed by matched related donor allogeneic transplantation with DFS of 65±9% at 6 years. These three clinical trials have established a strong foundation for the development of future studies focusing on further risk group stratification and the development of novel, molecularly-targeted therapies.

Original languageEnglish (US)
Pages (from-to)2054-2062
Number of pages9
JournalLeukemia
Volume19
Issue number12
DOIs
StatePublished - Dec 2005

Keywords

  • Acute myeloid leukemia
  • Bone marrow transplantation
  • Pediatrics

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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