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Abstract
Acute myeloid leukemia (AML) accounts for 20% of the pediatric acute leukemias. The incidence rate of AML among children is substantially lower than in adults, but probabilities of long-term survival are evidently better. Over the past decades, the application of intensive chemotherapy protocols, more precise indications of bone marrow transplantation (BMT) and the best clinical support managed to improve the survival of these patients, around 50% to 75%. However, relapse rates remain high (25 to 40%) after primary treatment. GATLA has carried BFM-based protocols for AML since 1983. The protocol form AMLP 8-GATLA´07, from August 2007 to August 2017, 226 evaluable AML patients were accrued, median age 8 years (r: 0.1 to 18 a). acute promyelocytic leukemia (LPA) and AML and Down syndrome were evaluated separately. It is divided into 2 risk groups: standard risk (SR) and high risk (HR) according to cytogenetic / molecular and response at day 15 of the induction. The treatment was double induction: AIE + HAM, consolidation: Ai + haM, intensification: etoposide and cytarabine and maintenance only for HR is that were not candidates for transplantation. Advances in molecular, cytogenetic biology together with the international experience of other cooperative groups have currently defined new challenges (diagnosis, risk stratification, treatment regimen and clinical support) for AML, taking this into account, the pediatric group GATLA designed a new Treatment Guide, active since April 2018.
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