Risk-Stratified Treatment for Acute Myeloid Leukemia

Abstract

With the improvement in the treatment outcome of pediatric acute myeloid leukemia (AML), treatment stratification based on prognostic factors became important for further improvement in treatment results and QOL of children with AML. Children treated in the Japan cooperative study ANLL91 (started August 1991) had a 7-year event-free survival rate of 55.2%. This result was superior to those achieved in other clinical trials reported at that time. Analysis of ANLL91 identified that cytogenetics, response to induction therapy, age at onset, and initial WBC counts were predictive of outcome. Based on these results and reports of other pediatric AML clinical trials, the Japan cooperative study AML99 was planned for testing the concept of risk-stratified treatment and opened in January 2000. The results of ANLL91 study and the interim reports of AML99 study are presented and risk group stratifications in recent pediatric AML clinical trials are discussed.