Analysis The Results Of 91 Childhood Acute Myeloid Leukemia Treated With 2015-AML03 Protocol

Objective:Summarize the efficacy of 2015-AML03 Protocol for treatment of 91 Children with Acute Myeloid Leukemia(AML)and analysis the prognostic factors.Methods:Ninety-onepatientswith AML(non-M3)received Treatment of 2015-AML03 Protocol diagnosed from November 18,2015 to May 22,2018 in Chongqing Medical University.Use SPSS 24.0 software and take The Kaplan-Meier survival analysis method and Cox regression model to analysis the prognostic factors,Log-rank test was used to compare survival among different groups.Results:The 2015-AML03 protocol includes induction I,induction II,intensification I and intensification II.Of all the 91 children,21 children gave up or died in the course of treatment.The remaining 70 children completed the protocol which include 54 patients completed 4 courses of chemotherapy and 16 patients received Allo-HSCT after 1-3 chemotherapy courses when they reached bone marrow remission.The median time of completing four-course chemotherapy is 142 days.Post induction?,85.4%reached bone marrow complete remission(CR),48.1%MRD<0.1%.Post induction?95.2%reached bone marrow CR,76.2%MRD<0.1%.The3-year Event Free Survival(EFS)is 53.7%±6.9%and the 3-year Overall Survival(OS)is 69.5%±6.2%.Univariate analysis indicate MLL positive?WBC?100*10~9/L?IR(intermediate risk)or HR(high risk)are associated with high Relapse rate(RR),WBC?100*10~9/L?MRD at 28 Day after induction??0.1%?AML1/ETO negative and IR or HR have bad effect with EFS.IR or HR and MRD at 28 Day after induction??0.1%have bad effect with OS.Multivariate analysis show that WBC?100*10~9/L?IR or HR have bad effect on RR,IR or HR?MRD at 28 Day after induction??0.1%are associated with low OS,IR or HR has bad effect with EFS.3 year OS of children with HSCT and not with HSCT are 85.6%±7.8%vs62.5%±8.2%(p=0.144),3 year OS of HSCT before relapse is 94.7%±5.1%.Conclusion:2015-AML03 protocol has good effect and Post induction children can rapidly reach bone marrow remission.3 year EFS of children with AML can reach 53.7%±6.9%and 3 year OS is 69.5%±6.2%.The risk level classification based on cytogenetics and molecular biology and the early treatment response MRD at 28 Day after induction?influence EFS and OS.Bone marrow not reaching CR at 28 Day after induction?is not a factor to survive and prognosis.HSCT before relapse can improve OS.