Cycles of pre-transplant chemotherapy in pediatric AML and the effect on relapse and leukemia free survival
Mentor Name: Caitlin Elgarten
The current approach for high-risk pediatric acute myeloid leukemia (AML) is to induce complete remission (CR) with intensive cytotoxic chemotherapy and to proceed to an allogenic blood marrow transplant (allo-BMT) to consolidate the remission and provide graft versus leukemia. Historically, 3 cycles of upfront chemotherapy have been given to both attain and hold a CR while arranging the best donor source and preparing for a safe transplant. More recently, however, many centers have been able to proceed more rapidly to allo-BMT as soon as a CR was attained, with only 2 total chemotherapy cycles. The goal of this project is to compare leukemia free survival (LFS), relapse rates, and time of relapse of high-risk AML patients who proceeded to allo-BMT in first CR following 1 additional cycle versus patients in first CR who completed 2 or more cycles of chemotherapy. We will be working with an established database of high-risk AML patient records as well as pediatric oncologists at several other hospitals across the U.S. to compile results. The project will determine whether an additional upfront cycle of chemotherapy provides benefits or whether little gain is added with subsequent cycles.
