Treatment results in childhood AML, with special reference to the German studies BFM-78 and BFM-83.

The number of children with acute myelogenous leukemia (AML) who achieve remission and the number of long-term survivors have increased in the last 10 years owing to intensified chemotherapy and better supportive care. This report reviews nine pediatric studies, particularly the German AML studies BFM-78 and BFM-83. A total of 294 children with AML under 17 years of age entered the AML studies BFM-78 (n=151) and BFM-83 (n = 143) between December 1978 and January 1986. The second study is still open for patient entry. The treatment in the first study consisted of a seven-drug regimen over a period of 8-10 weeks, together with prophylactic cranial irradiation, and was followed by maintenance therapy with 6-thioguanine and cytosine arabinoside (Ara-C) for 2 years and additional Adriamycin during the 1st year [1]. In the BFM-83 study an 8-day induction with Ara-C, daunorubicin, and VP16 precedes the BFM -78 protocol. The initial patient data of the two studies are in general comparable age: median 9.11 and 9.3 years; sex: boys 54% and 52%; WBC: median (x 103 /~l) 24.0 and 28.5; initial CNS involvement: 9% and 7%, respectively. Extramedullary organ involvement (excluding liver and spleen enlargement) was seen more often in the BFM-83 study (32%);