Unification of Treatment of Childhood Acute Myeloid Leukemia in the Czech
Republic According to AML-BFM 93 Study Protocol
Starý J., 1Gajdoš P., 2Blažek B., 2Ptoszková H. , 3Hrstková H., 3Kopečná L., ...........
II. dětská klinika 2. LF UK a FNM, Praha 1Státní zdravotní ústav, Praha 2Dětská klinika FNsP, Ostrava ...........
Background. Acute myeloid leukemia (AML) in children is rare. Although more resistant to chemotherapy than
acute lymphoblastic leukemia, its responsiveness and survival rates have considerably improved during the last 15
years by virtue of intensification of chemotherapy and due to the better supportive care. Relapses still remain the
main cause of treatment failure. Management of children with AML was unified in the Czech Republic in 1993
according to AML-BFM 93 Study protocol.
Methods and Results. Treatment results were evaluated in 61 patients, of whom 45 (73.8%) achieved complete
remission. Five-year event-free-survival (EFS) was found in 42.3%, and overall survival was 45.3%. Prognosis of
the standard-risk patients was significantly better than in the high-risk group (EFS 62.5% vs. 29.7%, p=0.03). The
most important prognostic factor was the early treatment response. Compared to chemotherapy, allogeneic stem-cell
transplantation did not significantly improve the outcome of high-risk patients.
Conclusions. Treatment results of children with AML in the Czech Republic are comparable to those achieved by
leading leukemia study groups in the world. The aim of the next study is to increase the complete-remission rate by
reducing early deaths.
Acute myeloid leukemia, children, chemotherapy, stem cell transplantation.