OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press64510.17650/1818-8346-2009-0-1-5-13HEMATOLOGIC MALIGNANCIES: TREATMENT, SUPPORTIVE CAREГЕМОБЛАСТОЗЫ: ЛЕЧЕНИЕ, СОПРОВОДИТЕЛЬНАЯ ТЕРАПИЯProtocol AML-MM-2000 treatment results of unfavorable prognostic group in children with acute myeloid leukemiaРезультаты лечения острого миелоидного лейкоза у детей группы неблагоприятного прогноза по протоколу ОМЛ-ММ-2000KirsanovaN. P.КирсановаН. П.
Belarus

Minsk

Минск

AleinikovaO. V.АлейниковаО. В.
Belarus

Minsk

Минск

KustanovichA. M.КустановичА. М.
Belarus

Minsk

Минск

SavitskayT. V.СавицкаяТ. В.
Belarus

Minsk

Минск

YutskevichR. I.ЮцкевичР. И.
Belarus

Minsk

Минск

VolochnikE. V.ВолочникЕ. В.
Belarus

Minsk

Минск

BaidunL. V.БайдунЛ. В.
Russian Federation
MareikoYu. E.МарейкоЮ. Е.
Belarus

Minsk

Минск

StronginYu. S.СтронгинЮ. С.
Belarus

Minsk

Минск

MinakovskayN. V.МинаковскаяН. В.
Belarus

Minsk

Минск

MigalN. V.МигальН. В.
Belarus

Minsk

Минск

ProleskovskayI. V.ПролесковскаяИ. В.
Belarus

Minsk

Минск

EmelyanovaI. V.ЕмельяноваИ. В.
Belarus

Minsk

Минск

KarasO. V.КарасьО. В.
Belarus

Minsk

Минск

DrekovA. G.ДрековА. Г.
Belarus

Minsk

Минск

MaschanM. M.МасчанМ. М.
Russian Federation
LitvinovD. V.ЛитвиновД. В.
Russian Federation
MyakovaN. V.МяковаН. В.
Russian Federation
SkorobogatovaE. V.СкоробогатоваЕ. В.
Russian Federation
BaidildinaD. D.БайдильдинаД. Д.
Russian Federation
KalininaI. I.КалининаИ. И.
Russian Federation
SolopovaG. G.СолоповаГ. Г.
Russian Federation
SuntsovaE. V.СунцоваЕ. В.
Russian Federation
PetrovaU. N.ПетроваУ. Н.
Russian Federation
HachatryanL. A.ХачатрянЛ. А.
Russian Federation
ScheiderM. M.ШнейдерМ. М.
Russian Federation
MaschanA. A.МасчанА. А.
Russian Federation
Republic Centre for Paediatric Oncology and HaematologyРеспубликанский научно-практический центр детской онкологии и гематологииRussian Children Clinical HospitalРоссийская детская клиническая больницаFederal Research Center of Pediatric Hematology, Oncology and ImmunologyФедеральный научно-клинический центр детской гематологии, онкологии и иммунологии Минздравсоцразвития24022009151323112022231120222009https://oncohematology.abvpress.ru/ongm/article/view/645

Protocol AML-MM-2000 treatment results of unfavorable prognostic group in children with primary acute myeloid leukemia (AML) in Russia and Belarus are presented. 105 children at the age from 2 weeks till 18 years (a median age — 10.8 years) are included in the study. In 91 patients (86.7%) hematological remission have reached, from them 34 patients (37.4%) are in the first continuous complete remission (CCR). 6-years overall survival (OS), event-free survival (EFS) and relapse-free survival (RFS) rate for all group of patients was 0.35 ±} 0.05; 0.32 ±} 0.04 and 0.43 ±} 0.05, respectively. Survival analysis of children with different cytogenetic anomalies has allowed to define two prognostic groups of patients: the intermediate prognosis, including patients with normal kariotype and t(9;11) which EFS and RFS rate was 40—50%, and unfavorable prognosis with EFS and RFS rate less than 40%. The efficiency analysis of three postremission therapy type (allogeneic and autological hematopoietic stem cells transplantation (HSCT) and chemotherapy (HT)) in intermediate and unfavorable prognostis groups was carried out. High efficiency of related HLA-identical HSCT in patients both intermediate and unfavorable prognostis groups have been shown. Autological HSCT is possible in intermediate prognosis patients with absence of HLA-identical siblings and in unfavorable prognosis patients with absence of HLA-identical unrelated donor.

В работе представлены результаты лечения детей с первично диагностированным острым миелоидным лейкозом (ОМЛ) группы неблагоприятного прогноза по протоколу ОМЛ-ММ-2000 в России и Беларуси. В исследование были включены 105 детей, медиана возраста составила 10,8 года (от 2 нед до 18 лет 9 мес). Клинико-гематологическая ремиссия достигнута у 91 (86,7%) пациента, из них в первой продолжительной ремиссии (ППР) находятся 34 (37,4%) ребенка. Вероятность 6-летней общей (ОВ), бессобытийной (БСВ) и безрецидивной (БРВ) выживаемости для всей группы пациентов составила 0,35±}0,05; 0,32±}0,04 и 0,43±}0,05 соответственно. Проведенный анализ результатов выживаемости разнородной по цитогенетическим аномалиям когорты детей с ОМЛ позволил выделить 2 прогностические группы пациентов: промежуточного прогноза, включающую больных с нормальным кариотипом и с t(9;11), вероятность БСВ и БРВ которых была 40—50%; неблагоприятного прогноза, у которых аналогичные показатели были <40%. Проведен анализ эффективности 3 постремиссионных видов терапии (аллогенная, аутологичная трансплантация гемопоэтических стволовых клеток — ТГСК и полихимиотерапия —ПХТ) у пациентов группы промежуточного и неблагоприятного прогноза. Показана высокая эффективность родственной совместимой ТГСК в отношении сохранения ремиссии у пациентов как промежуточного, так и неблагоприятного прогноза. При отсутствии совместимого сиблинга у больных промежуточного прогноза и идентичного аллогенного донора у пациентов неблагоприятного прогноза возможно проведение им ауто-ТГСК.

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