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Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol)

Background: Due to the poor outcomes achieved in acute myeloid leukaemia (AML) treatment, the Red Cross War Memorial Children's Hospital (RCWMCH) Oncology service changed from a BFM-87 based protocol to one based on MRC-AML15 in 2007. Rationale: This study was designed to assess the outcomes and tre...

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Main Author: Thomas, Karla Mari
Other Authors: Davidson, Alan
Format: Thesis
Language:English
Published: Department of Paediatrics and Child Health 2018
Subjects:
Paediatric Oncology
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access_status_str Open Access
author Thomas, Karla Mari
author2 Davidson, Alan
author_browse Davidson, Alan
Thomas, Karla Mari
author_facet Davidson, Alan
Thomas, Karla Mari
author_sort Thomas, Karla Mari
collection Thesis
description Background: Due to the poor outcomes achieved in acute myeloid leukaemia (AML) treatment, the Red Cross War Memorial Children's Hospital (RCWMCH) Oncology service changed from a BFM-87 based protocol to one based on MRC-AML15 in 2007. Rationale: This study was designed to assess the outcomes and treatment - related toxicity among children treated with RCWMCH protocol Rx 2071. Methods: This was a retrospective review of AML patients treated with Rx2071 between 2007 and 2012 at RCWMCH. Patients with acute promyelocytic leukaemia (APL) and Down Syndrome were excluded. Risk was assigned by cytogenetics. Good risk patients were those with t(8;21), t(16,16) and inv(16). Poor and standard risk included all other cytogenetics according to MRC-AML15. Data pertaining to toxicity was obtained from patient folders. Results: Thirty five children were treated on Rx 2071 during the study period. Males comprised 51.4% (18/35) and females 48.6% (17/35). Age at diagnosis ranged from 0.33 to 12.51 years with the median being 5.68 years. Follow-up from remission in the patients who survived ranged from 1 year 10 months to 9 years 1 month with a median of 62.5 months. Fifteen patients had favourable cytogenetics. Event free survival (EFS) for the good risk group was 85.6%. Twenty patients presented with standard/poor risk cytogenetics. Five patients were deemed poor risk with one having major karyotype abnormalities and four not achieving remission. The remaining fifteen were deemed standard risk by cytogenetics. EFS in this group was 32.4%. Two standard/poor risk patients were transplanted in first complete remission (CR1) and two patients were transplanted in second complete remission. (CR2) Patients had a median of four neutropaenic fevers, and required a median of eight packed cell and eleven platelet transfusions. There were 39 positive blood cultures. There were no chemotherapy related deaths. Discussion: The EFS for good risk patients is excellent but the EFS for standard/poor risk group is not on par with results being achieved in high income countries. The toxicity is not excessive on Rx2071. The results achieved on this protocol were superior to that of the previous BFM- based protocol. Conclusion: The results of this study support the continued use of Rx2071 at RCWMCH.
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:48:23.508Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2018
publishDateRange 2018
publishDateSort 2018
publisher Department of Paediatrics and Child Health
publisherStr Department of Paediatrics and Child Health
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/27378 Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol) Thomas, Karla Mari Davidson, Alan Paediatric Oncology Background: Due to the poor outcomes achieved in acute myeloid leukaemia (AML) treatment, the Red Cross War Memorial Children's Hospital (RCWMCH) Oncology service changed from a BFM-87 based protocol to one based on MRC-AML15 in 2007. Rationale: This study was designed to assess the outcomes and treatment - related toxicity among children treated with RCWMCH protocol Rx 2071. Methods: This was a retrospective review of AML patients treated with Rx2071 between 2007 and 2012 at RCWMCH. Patients with acute promyelocytic leukaemia (APL) and Down Syndrome were excluded. Risk was assigned by cytogenetics. Good risk patients were those with t(8;21), t(16,16) and inv(16). Poor and standard risk included all other cytogenetics according to MRC-AML15. Data pertaining to toxicity was obtained from patient folders. Results: Thirty five children were treated on Rx 2071 during the study period. Males comprised 51.4% (18/35) and females 48.6% (17/35). Age at diagnosis ranged from 0.33 to 12.51 years with the median being 5.68 years. Follow-up from remission in the patients who survived ranged from 1 year 10 months to 9 years 1 month with a median of 62.5 months. Fifteen patients had favourable cytogenetics. Event free survival (EFS) for the good risk group was 85.6%. Twenty patients presented with standard/poor risk cytogenetics. Five patients were deemed poor risk with one having major karyotype abnormalities and four not achieving remission. The remaining fifteen were deemed standard risk by cytogenetics. EFS in this group was 32.4%. Two standard/poor risk patients were transplanted in first complete remission (CR1) and two patients were transplanted in second complete remission. (CR2) Patients had a median of four neutropaenic fevers, and required a median of eight packed cell and eleven platelet transfusions. There were 39 positive blood cultures. There were no chemotherapy related deaths. Discussion: The EFS for good risk patients is excellent but the EFS for standard/poor risk group is not on par with results being achieved in high income countries. The toxicity is not excessive on Rx2071. The results achieved on this protocol were superior to that of the previous BFM- based protocol. Conclusion: The results of this study support the continued use of Rx2071 at RCWMCH. 2018-02-07T09:11:43Z 2018-02-07T09:11:43Z 2017 Master Thesis Masters MPhil http://hdl.handle.net/11427/27378 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences University of Cape Town
spellingShingle Paediatric Oncology
Thomas, Karla Mari
Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol)
thesis_degree_str Master's
title Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol)
title_full Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol)
title_fullStr Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol)
title_full_unstemmed Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol)
title_short Interim analysis of Acute Myeloid Leukaemia treated on the Red Cross Children's Hospital Rx 2071 (adapted from the MRC AML 15 protocol)
title_sort interim analysis of acute myeloid leukaemia treated on the red cross children s hospital rx 2071 adapted from the mrc aml 15 protocol
topic Paediatric Oncology
url http://hdl.handle.net/11427/27378
work_keys_str_mv AT thomaskarlamari interimanalysisofacutemyeloidleukaemiatreatedontheredcrosschildrenshospitalrx2071adaptedfromthemrcaml15protocol

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