Advances in the reduction of mortality from childhood acute myeloid leukemia (AML) were reviewed

09-13-2006

According to recent research from the United States, "Childhood and adolescent AML is traditionally one of the hardest childhood cancers to successfully treat and had all overall survival well under 10% in the 1960s. Initial progress was made by 3 major events: (1) active chemotherapeutic agents were identified which led to remissions for the first time in this disease; (2) cooperative groups were instituted leading to important clinical trials; and (3) several single institutions began experimenting with the role of allogeneic matched sibling donor (MSD) BMT as effective intensification."

"Over the last 25 years, the cure rate has improved from <20% to 50% or higher," explained W.G. Woods and colleagues, Children's Healthcare Atlanta/Emory University. "Most of the clinical research during this time of great advancement focused on 2 major themes: (1) the role of aggressive induction therapy in not only improving CR rates but in post-remission outcomes; and (2) the role of aggressive post-remission therapy in further improving survival, with all emphasis on high-dose Ara C-based chemotherapy, BMT, and supportive care. But we have 'miles to go before we sleep.'

"Some of the challenges that will lead to ongoing reduction of population-based mortality for AML through young adulthood include: (1) improving access of adolescents to pediatric AML therapy; (2) stratification by prognostic factors; (3) individualized therapy based on individual genetics and leukemia cell biology; (4) and the use of novel therapies including targeted immuno-conjugates and 'small molecules' which disrupt abnormal signal transduction pathways."

The researchers concluded, "This brief review looks at both the advances over the last 3 decades as well as discusses the challenges moving forward for ultimately curing all children with this disease."

Woods and colleagues published their study in Pediatric Blood & Cancer (Curing childhood acute myeloid leukemia (AML) at the half-way point: Promises to keep and miles to go before we sleep. Pediatr Blood Cancer, 2006;46(5):565-569).

For additional information, contact W.G. Woods, Children's Healthcare Atlanta Emory University, Aflac Cancer Center, Dept. Pediatrics, 2015 Uppergate Dr., Suite 404, Atlanta, GA 30322, USA.

Publisher contact information for the journal Pediatric Blood & Cancer is: Wiley-Liss, Division John Wiley & Sons Inc., 111 River St., Hoboken, NJ 07030, USA.