Treatment and survival of children with AML in Slovenia in the period from 1991 to 2010

Abstract

Background: A review of treatment and survival of children with acute mieloid leukemia (AML) in Slovenia between the years 1991 and 2010. Methods: We collected demographic data and the data about timing and course of treatment. We monitored the presence of remission (R), event-free survival (EFS), the incidence of recurrence of the disease (RD), secondary neoplasms (SN), secondary AML, the proportion of patients treated with hematopoietic stem cell transplantation (HSCT) and causes of death. We estimated two-and five-year survival (2OS, 5OS), compared them by age group, risk group and the presence of remission. Results: 50 patients, 18 boys (36 %) and 32 girls (64 %) were treated. Four patients had secondary AML. 18 patients (36 %) were treated with HSCT, 9 in the first remission. 2OS in all patients was 63.7 ± 6.8 %, 5OS was 55.0 ± 7.2 %. There was no difference in 2OS and 5OS between age groups (0–5 years, 6–10 years, more than 10 years). All patients with standard risk (SR) lived more than two years; 2OS in high-risk (HR) patients was 56.7 ± 7.7 %.  The difference in survival between the risk groups was significant (p = 0.05).  The presence of remission was important for prediction of the outcome of the disease (p = 0.01). 2OS of 77.8 ± 7.4 % was archived in patients in remission, 5OS was 63.8 ± 8.8 %. In patients who failed to achieve remission 2OS and 5OS were the same (37.5 ± 12.1 %). 2OS was 62 % in patients who underwent HSCT in the first remission. 17 patients (34 %) had RD. 23 patients (64 %) died, 14 (61 %) due to progression of AML. Conclusions: Our results of AML treatment are comparable  with the results from other European centers. Overall survival was better in the standard risk (SR) group and  in  patients who achieved remission after the initial cycle of chemotherapy. We observed a trend of overall survival  improvement in the observation period, which was not statistically significant.