BIOMAT Database Logo BIOMAT Database Logo

Impact of high-dose cytarabine and asparaginase intensification on childhood acute myeloid leukemia: a report from the Childrens Cancer Group. 1993

R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
Children's Hospital Research Foundation, Cincinnati, OH.

OBJECTIVE The purpose of this review was to determine the impact of high-dose cytarabine and asparaginase intensification, administered shortly after remission induction, on the outcome of childhood acute myeloid leukemia (AML). METHODS Three consecutive Childrens Cancer Group (CCG) trials of acute myeloid leukemia, CCG 251 (1979 to 1983), CCG 213P (1983 to 1985), and CCG 213 (1985 to 1989) with a total of 1,294 patients, were reviewed and provide the basis of this report. RESULTS CCG 213P demonstrated the importance of dose interval, in that two courses of cytarabine and asparaginase administered at 7-day intervals gave superior 5-year survival rates (58% v 41% from the end of induction, P < .04) to the same therapy administered at 28-day intervals. CCG 213 showed that there was no advantage to the maintenance therapy used for patients who received two courses of cytarabine and asparaginase at 7-day intervals (5-year survival, 68% [no maintenance] v 44% [maintenance] from the end of consolidation, P < .01). Inclusion of the 7-day interval cytarabine/asparaginase intensification was accompanied by an overall improvement in 5-year survival rates from diagnosis when compared with historical controls (CCG 213, 36% v CCG 251, 29%, P < .02) although other differences between these studies could also be responsible for the improvement seen. CONCLUSIONS High-dose cytarabine and asparaginase intensification eliminated the benefit of prolonged maintenance therapy in childhood AML and was accompanied by an overall improvement in survival.

UI MeSH Term Description Entries
D007951 Leukemia, Myeloid Form of leukemia characterized by an uncontrolled proliferation of the myeloid lineage and their precursors (MYELOID PROGENITOR CELLS) in the bone marrow and other sites. Granulocytic Leukemia,Leukemia, Granulocytic,Leukemia, Myelocytic,Leukemia, Myelogenous,Myelocytic Leukemia,Myelogenous Leukemia,Myeloid Leukemia,Leukemia, Monocytic, Chronic,Monocytic Leukemia, Chronic,Chronic Monocytic Leukemia,Chronic Monocytic Leukemias,Granulocytic Leukemias,Leukemia, Chronic Monocytic,Leukemias, Chronic Monocytic,Leukemias, Granulocytic,Leukemias, Myelocytic,Leukemias, Myelogenous,Leukemias, Myeloid,Monocytic Leukemias, Chronic,Myelocytic Leukemias,Myelogenous Leukemias,Myeloid Leukemias
D011336 Probability The study of chance processes or the relative frequency characterizing a chance process. Probabilities
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003561 Cytarabine A pyrimidine nucleoside analog that is used mainly in the treatment of leukemia, especially acute non-lymphoblastic leukemia. Cytarabine is an antimetabolite antineoplastic agent that inhibits the synthesis of DNA. Its actions are specific for the S phase of the cell cycle. It also has antiviral and immunosuppressant properties. (From Martindale, The Extra Pharmacopoeia, 30th ed, p472) Ara-C,Arabinofuranosylcytosine,Arabinosylcytosine,Cytosine Arabinoside,Aracytidine,Aracytine,Cytarabine Hydrochloride,Cytonal,Cytosar,Cytosar-U,beta-Ara C,Ara C,Arabinoside, Cytosine,Cytosar U,beta Ara C
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000971 Antineoplastic Combined Chemotherapy Protocols The use of two or more chemicals simultaneously or sequentially in the drug therapy of neoplasms. The drugs need not be in the same dosage form. Anticancer Drug Combinations,Antineoplastic Agents, Combined,Antineoplastic Chemotherapy Protocols,Antineoplastic Drug Combinations,Cancer Chemotherapy Protocols,Chemotherapy Protocols, Antineoplastic,Drug Combinations, Antineoplastic,Antineoplastic Combined Chemotherapy Regimens,Combined Antineoplastic Agents,Agent, Combined Antineoplastic,Agents, Combined Antineoplastic,Anticancer Drug Combination,Antineoplastic Agent, Combined,Antineoplastic Chemotherapy Protocol,Antineoplastic Drug Combination,Cancer Chemotherapy Protocol,Chemotherapy Protocol, Antineoplastic,Chemotherapy Protocol, Cancer,Chemotherapy Protocols, Cancer,Combinations, Antineoplastic Drug,Combined Antineoplastic Agent,Drug Combination, Anticancer,Drug Combination, Antineoplastic,Drug Combinations, Anticancer,Protocol, Antineoplastic Chemotherapy,Protocol, Cancer Chemotherapy,Protocols, Antineoplastic Chemotherapy,Protocols, Cancer Chemotherapy
D001215 Asparaginase A hydrolase enzyme that converts L-asparagine and water to L-aspartate and NH3. EC 3.5.1.1. Asparaginase II,Asparaginase medac,Asparagine Deaminase,Colaspase,Crasnitin,Elspar,Erwinase,Kidrolase,Leunase,Paronal,Deaminase, Asparagine,medac, Asparaginase
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

Related Publications

R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
High-dose cytarabine for intensification of early therapy of childhood acute myeloid leukemia: a Pediatric Oncology Group study.
April 1991, Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
[Sequential high-dose cytarabine therapy in combination with asparaginase in acute myeloid leukemia].
December 1988, Onkologie,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
Mitoxantrone and cytarabine induction, high-dose cytarabine, and etoposide intensification for pediatric patients with relapsed or refractory acute myeloid leukemia: Children's Cancer Group Study 2951.
August 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
Morphologic, immunologic, and cytogenetic classification of acute myeloid leukemia and myelodysplastic syndrome in childhood: a report from the Childrens Cancer Group.
January 1996, Leukemia,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
[High-dose cytarabine therapy in acute myeloid leukemia].
August 1986, [Rinsho ketsueki] The Japanese journal of clinical hematology,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
High-dose cytarabine induction for acute myeloid leukemia.
July 1996, Blood,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
A clinical report on high‑dose cytarabine therapy for children with acute myeloid leukemia.
November 2022, Molecular and clinical oncology,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
Prolonged second remissions in childhood acute lymphocytic leukemia: a report from the Childrens Cancer Study Group.
January 1983, Medical and pediatric oncology,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
Patients with acute myeloid leukemia and RAS mutations benefit most from postremission high-dose cytarabine: a Cancer and Leukemia Group B study.
October 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
R J Wells, and W G Woods, and B C Lampkin, and M E Nesbit, and J W Lee, and J D Buckley, and C Versteeg, and G D Hammond
Impact of Asparaginase Discontinuation on Outcome in Childhood Acute Lymphoblastic Leukemia: A Report From the Children's Oncology Group.
June 2020, Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
Copied contents to your clipboard!