• Drugs used in remission induction include daunorubicin, etoposide, cytarabine and mitoxantrone (mitozantrone).

• Drugs used in post induction and consolidation treatment include amsacrine, high-dose cytarabine, L-asparaginase, etoposide and mitox-antrone (mitozantrone).

• Good risk patients are those with t(8;21), t(15;17) and inv (16)— together accounting for around 20-25% overall; standard risk patients are those without good risk genetic changes but that respond well and remit after one course of chemotherapy (65% overall), and poor risk are those without good genetics who have residual disease at the start of course 2 of treatment (around 10% of the total).

• Long term EFS for good risk children is around 75-80%, for standard risk around 60-65%, and for poor risk around 15%.

• Allogeneic BMT as consolidation therapy of first remission is reserved for children in standard and poor risk groups. It is also used as a salvage strategy for good risk patients who relapse.

• The role of autologous stem cell rescue following myeloablative conditioning in children with AML has not been established.

• The need for skilled supportive therapy confines AML therapy to specialist units.

0 0

Post a comment