In a nutshell
This study aimed to investigate the long-term outcomes for children with acute myeloid leukemia (AML) who were treated with low-dose chemotherapy (LDC).
This study concluded that there is a high remission rate for these patients and that long-term survival is similar to patients who received standard-dose chemotherapy (SDC).
Some background
Treatments for children with AML involve very intensive chemotherapy and/or stem cell transplantation (SCT). However, intensive chemotherapy may have important side effects in long-term survivors. Therefore, it is important to evaluate lower-intensity chemotherapies in children with AML.
A small study reported that treating children with AML with low-dose chemotherapy (LDC) had similar remission rates as standard-dose chemotherapy (SDC). LDC involved a combination of low-dose cytarabine (Cytosar-U) and mitoxantrone (Novantrone) or omacetaxine mepesuccinate (Synribo) with granulocyte colony-stimulating factor (G-CSF; Neupogen). However, the long-term outcomes of children with AML treated with LDC are still unknown.
Methods & findings
This study involved 183 children with AML. 83 patients were treated with LDC. 100 patients were treated with SDC regimen. They were followed up for an average of 50 months.
Similar outcomes were seen between groups. 88% of the LDC group had complete remission compared to 86.4% of the SDC group. The 5-year survival rate without complication from the AML was 61.4% for the LDC group compared to 65.2% for the SDC group.
Overall, 72.7% of the LDC group and 72.5% of the SDC group were alive after 5 years. 20.5% of the LDC group and 17.6% of the SDC group had relapsed during 5 years.
Patients in the LDC group had significantly shorter times until the blood cell counts were normalized compared to the SDC group. They also had significantly lower numbers of severely low white blood cell counts with fever (61.4%) compared to the SDC group (91%). LDC was also associated with lower treatment and complication-treatment costs compared to SDC.
The bottom line
This study concluded that long-term outcomes with LDC are similar to SDC in children with AML.
The fine print
Patients treated with SDC had more high-risk disease compared to those treated with LDC.
Published By :
Blood advances
Date :
Apr 13, 2021
