A POPULATION-BASED STUDY OF 272 CHILDREN WITH ACUTE MYELOID-LEUKEMIA TREATED ON 2 CONSECUTIVE PROTOCOLS WITH DIFFERENT INTENSITY - BEST OUTCOME IN GIRLS, INFANTS, AND CHILDREN WITH DOWNS-SYNDROME

From July 1984 the five Nordic countries (Denmark, Finland, Iceland, N orway and Sweden) have registered all children with acute myeloid leuk aemia (AML) and treated them on two consecutive protocols of different intensity (NOPHO-84 and NOPHO-88). We probably have information on ev ery child with this diagnosis in our region. We found an annual incide nce of AML of 0.7 new cases per 100 000 children < 16 gears of age, We observed a distinct peak of incidence in the first 2 years of life, C hildren with Down's syndrome accounted for 13% of all cases. Eighty of 105 cases treated on NOPHO-84 achieved remission (75%), In NOPHO-88, 100/118 patients entered remission (85%). The overall event-free survi val (p-EFS) for the two studies was 0.32 for NOPHO-84 and 0.42 for NOP HO-88. The majority of relapses occurred within 2 years of diagnosis. When looking for prognostic factors the strongest significant adverse factor found was male sex. Children with Down's syndrome (n = 35) had a very favourable outcome if they received therapy according to protoc ol, and infants (n = 26) had a superior outcome compared to children 1 -2 years or >10 years of age at diagnosis.