Treatment for myeloid leukaemia of Down syndrome: population-based experience in the UK and results from the Medical Research Council AML 10 and AML 12 trials

Rao, Anupama, Hills, Robert Kerrin ORCID: https://orcid.org/0000-0003-0166-0062, Stiller, Charles, Gibson, Brenda E. S., de Graaf, Siebold S. N., Hann, Ian M., O'Marcaigh, Aengus, Wheatley, Keith and Webb, David K. H. 2006. Treatment for myeloid leukaemia of Down syndrome: population-based experience in the UK and results from the Medical Research Council AML 10 and AML 12 trials. British Journal of Haematology 132 (5) , pp. 576-583. 10.1111/j.1365-2141.2005.05906.x

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Abstract

Down syndrome (DS) children are at an increased risk of developing myelodysplasia and acute myeloid leukaemia (AML). We retrospectively analysed the population-based data on 81 children with myeloid leukaemia of Down syndrome (ML-DS) from the UK National Registry of Childhood Tumours and experience in the Medical Research Council (MRC) AML 10 and AML 12 trials, which enrolled 46 children with ML-DS from 1988 to 2002. Eight per cent of UK children with AML had DS, but DS children comprised only 5% of children registered in MRC trials. The unique clinical characteristics of ML-DS were confirmed. Overall survival (OS) of ML-DS at 5 years increased from 47% in UK children diagnosed from 1988 to 1995 to 75% in children diagnosed from 1996 to 2002. OS for DS children registered in AML 10 and AML 12 was 74% in 5 years and improved from AML 10 to AML 12 (56% vs. 83%) There was no significant difference in OS between DS and non-DS children (OS: 74% vs. 62%, P = 0.4) in the trials, but this result masked a significant increase in early death amongst DS children, with a significant reduction in mortality later on. Relapse was significantly reduced (3% vs. 39%, P = 0.0003), leading to the improved disease-free survival (83% vs. 56%, P = 0.02). Given the increased number of early treatment-related deaths, future treatment protocols should aim to reduce chemotherapy dosage or intensity whilst maintaining low rates of resistant and recurrent disease.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RM Therapeutics. Pharmacology
Uncontrolled Keywords:	Acute myeloid leukaemia ; Down syndrome ; Acute myeloid leukaemia-10 ; Acute myeloid leukaemia-12
Publisher:	Wiley-Blackwell
ISSN:	0007-1048
Last Modified:	24 Oct 2022 11:54
URI:	https://orca.cardiff.ac.uk/id/eprint/49725

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