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URL http://www.rockymountainbmt.com/news/Outcome-of-pediatric-acute-myeloid-leukemia-AML-was-not-improved-after-high-dose-daunorubicin-cytarabine-and-thioguanine-DAT-therapy-and-the-addition-of-cyclosporine-CsA-2734.html

Outcome of pediatric acute myeloid leukemia (AML) was not improved after high-dose daunorubicin, cytarabine, and thioguanine (DAT) therapy and the addition of cyclosporine (CsA)

08-23-2006

According to recent research published in the journal Blood, "Relapse is a major obstacle in the cure of AML. The Pediatric Oncology Group AML Study 9421 tested 2 different strategies to improve event-free survival (EFS) and overall survival (OS)."

"Patients were randomized to receive standard-dose DAT or high-dose DAT during induction," explained D. Becton and colleagues, Stanford University. "To interfere with P-glycoprotein (P-g p)-dependent drug efflux, the second randomization tested the benefit of CsA added to consolidation chemotherapy. Of the 282 children randomly assigned to receive standard DAT induction, 248 (87.9%) achieved remission compared to 253 (91%) of the 278 receiving high-dose DAT (p=ns).

"Children with HLA-identical sibling donors who achieved a complete remission received an allogeneic bone marrow transplant as consolidation. For the 83 patients receiving a matched related donor bone marrow transplantation (BMT), the 3-year disease-free survival (DFS) is 67%. Of the 418 children who achieved remission and went on to consolidation with and without CsA, the DFS was 40.6% and 33.9%, respectively (p=.24). Overexpression of P-gp was infrequent (14%) in this pediatric population."

The researchers concluded, "In this study, intensifying induction with high-dose DAT and the addition of CsA to consolidation chemotherapy did not prolong the durations of remission or improve overall survival for children with AML."

Becton and colleagues published their study in Blood (Randomized use of cyclosporin A (CsA) to modulate P-glycoprotein in children with AML in remission: Pediatric Oncology Group Study 9421. Blood, 2006;107(4):1315-1324).

For additional information, contact G.V. Dahl, Stanford University, School of Medicine, Dept. Pediatrics, Division Hematology Oncology, BMT, 1000 Welch Rd., Suite 300, Palo Alto, CA 94304, USA.

Keywords: Palo Alto, California, United States, Acute Myeloid Leukemia, Bone Marrow, Chemotherapy, Child Cancer, Cyclosporin A, Oncology, Pediatric Cancer, Pediatric Carcinomas, Cancer Therapy, Daunorubicin, Cytarabine, Thioguanine.

This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2006, Clinical Oncology Week via NewsRx.com.