Cd. Deheredia et al., RESULTS OF INTENSIVE CHEMOTHERAPY IN CHILDREN WITH JUVENILE CHRONIC MYELOMONOCYTIC LEUKEMIA - A PILOT-STUDY, Medical and pediatric oncology, 31(6), 1998, pp. 516-520
Background. The use of chemotherapy in juvenile chronic myelomonocytic
leukemia (J-CMML) has not generally been successful. Our previous exp
erience in 11 patients demonstrated that chemotherapy with low doses o
f daunorubicin or cytarabine resulted in a 90% fatal outcome and a med
ian survival rate of only 7 months. Procedure and Results. Between 198
5 and 1997, six children (five boys and one girl) aged 3-67 months (me
dian age: 20.5) were diagnosed with J-CMML and underwent intensive com
bination chemotherapy similar to that used for acute myeloblastic leuk
emia. Two patients with high-risk factors developed progressive diseas
e with fatal outcome at 5 and 18 months postdiagnosis, respectively. H
owever, four patients without poor prognosis indices responded and wer
e alive 145, 82, 51, and 6 months after diagnosis. Overall survival in
this small series at 7 years from diagnosis is 60% (CI: 17-100). Conc
lusions. The use of intensive combination chemotherapy in children wit
h J-CMML can result in long-term survival in some patients. (C) 1998 W
iley-Liss, Inc.