Acute myeloid leukemia, pediatric - historical

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main pediatric AML page for current regimens.

8 regimens on this page
8 variants on this page


Upfront induction therapy

7+3d (low-dose)

7+3d: 7 days of cytarabine + 3 days of daunorubicin

Regimen variant #1, 700/90

Study Years of enrollment Evidence Comparator Comparative Efficacy
Nesbit et al. 1994 (CCG 251) 1979-1983 Non-randomized portion of RCT

Chemotherapy

Two courses

References

  1. CCG 251: Nesbit ME Jr, Buckley JD, Feig SA, Anderson JR, Lampkin B, Bernstein ID, Kim TH, Piomelli S, Kersey JH, Coccia PF, O'Reilly RC, August C, Thomas ED, Hammond GD; Children's Cancer Group. Chemotherapy for induction of remission of childhood acute myeloid leukemia followed by marrow transplantation or multiagent chemotherapy: a report from the Childrens Cancer Group. J Clin Oncol. 1994 Jan;12(1):127-35. link to original article PubMed
    1. Pooled update: Smith FO, Alonzo TA, Gerbing RB, Woods WG, Arceci RJ; Children's Cancer Group. Long-term results of children with acute myeloid leukemia: a report of three consecutive phase III trials by the Children's Cancer Group: CCG 251, CCG 213 and CCG 2891. Leukemia. 2005 Dec;19(12):2054-62. link to original article PubMed

DAT

DAT: Daunorubicin, Ara-C (Cytarabine), Thioguanine
TAD: Thioguanine, Ara-C (Cytarabine), Daunorubicin
TAD9: Thioguanine, Ara-C (Cytarabine), Daunorubicin over 9 days

Regimen

Study Years of enrollment Evidence Comparator Comparative Efficacy
Steuber et al. 1991 (POG 8101) 1977-1981 Phase 3 (C) VADx Seems to have superior CR rate

Chemotherapy

DCTER

DCTER: Dexamethasone, Cytarabine, Thioguanine, Etoposide, Rubidomycin (Daunomycin)

Regimen

Study Years of enrollment Evidence Comparator Comparative Efficacy
Wells et al. 1994 (CCG 213) 1986-1989 Phase 3 (E-esc) 7+3d; standard-dose Did not meet efficacy endpoints
Woods et al. 1996 (CCG 2891) 1989-1993 Phase 3 (E-esc) DCTER; standard timing Superior DFS
Lange et al. 2007 (CCG 2961) 1996-2002 Phase 3 (C) IdaDCTER/DCTER Did not meet primary endpoints of RR/DFS

Glucocorticoid therapy

Chemotherapy

References

  1. CCG 213: Wells RJ, Woods WG, Buckley JD, Odom LF, Benjamin D, Bernstein I, Betcher D, Feig S, Kim T, Ruymann F, Smithson W, Srivastava A, Tannous R, Buckley CM, Whitt JK, Wolff L, Lampkin BC; Children's Cancer Group. Treatment of newly diagnosed children and adolescents with acute myeloid leukemia: a Childrens Cancer Group study. J Clin Oncol. 1994 Nov;12(11):2367-77. link to original article PubMed
    1. Pooled update: Smith FO, Alonzo TA, Gerbing RB, Woods WG, Arceci RJ; Children's Cancer Group. Long-term results of children with acute myeloid leukemia: a report of three consecutive phase III trials by the Children's Cancer Group: CCG 251, CCG 213 and CCG 2891. Leukemia. 2005 Dec;19(12):2054-62. link to original article PubMed
  2. CCG 2961: Lange BJ, Smith FO, Feusner J, Barnard DR, Dinndorf P, Feig S, Heerema NA, Arndt C, Arceci RJ, Seibel N, Weiman M, Dusenbery K, Shannon K, Luna-Fineman S, Gerbing RB, Alonzo TA. Outcomes in CCG-2961, a Children's Oncology Group phase 3 trial for untreated pediatric acute myeloid leukemia: a report from the children's oncology group. Blood. 2008 Feb 1;111(3):1044-53. Epub 2007 Nov 13. link to original article link to PMC article PubMed NCT00002798
  3. CCG 2891: Woods WG, Kobrinsky N, Buckley JD, Lee JW, Sanders J, Neudorf S, Gold S, Barnard DR, DeSwarte J, Dusenbery K, Kalousek D, Arthur DC, Lange BJ. Timed-sequential induction therapy improves postremission outcome in acute myeloid leukemia: a report from the Children's Cancer Group. Blood. 1996 Jun 15;87(12):4979-89. link to original article PubMed
    1. Pooled update: Smith FO, Alonzo TA, Gerbing RB, Woods WG, Arceci RJ; Children's Cancer Group. Long-term results of children with acute myeloid leukemia: a report of three consecutive phase III trials by the Children's Cancer Group: CCG 251, CCG 213 and CCG 2891. Leukemia. 2005 Dec;19(12):2054-62. link to original article PubMed

References

  1. POG 8101: Steuber CP, Civin C, Krischer J, Culbert S, Ragab A, Ruymann FB, Ravindranath Y, Leventhal B, Wilkinson R, Vietti TJ. A comparison of induction and maintenance therapy for acute nonlymphocytic leukemia in childhood: results of a Pediatric Oncology Group study. J Clin Oncol. 1991 Feb;9(2):247-58. link to original article PubMed

D-ZAPO

D-ZAPO: Daunomycin, 5-Azacytidine, Ara-C (Cytarabine), Prednisone, Oncovin (Vincristine)

Regimen

Study Years of enrollment Evidence
Baehner et al. 1979 (CCG 241) NR in abstract Non-randomized portion of RCT

Chemotherapy

Glucocorticoid therapy

References

  1. CCG 241: Baehner RL, Bernstein ID, Sather H, Higgins G, McCreadie S, Chard RL, Hammond D. Improved remission induction rate with D-ZAPO but unimproved remission duration with addition of immunotherapy to chemotherapy in previously untreated children with ANLL. Med Pediatr Oncol. 1979;7(2):127-39. link to original article PubMed

Mercaptopurine monotherapy

Regimen

Study Years of enrollment Evidence Comparator Comparative Efficacy
Heyn et al. 1960 1955-1957 Phase 3 (C) 6-MP & Azaserine Did not meet efficacy endpoints

Note: This was the first RCT of the Acute Leukemia Chemotherapy Cooperative Study Group A (ALCCSGA), subsequently renamed the Children's Cancer Group (CCG).

Chemotherapy

Continued for at least 28 days

References

  1. Heyn RM, Brubaker CA, Burchenal JH, Cramblett HG, Wolff JA; Acute Leukemia Chemotherapy Cooperative Study Group A. The comparison of 6-mercaptopurine with the combination of 6-mercaptopurine and azaserine in the treatment of acute leukemia in children: results of a cooperative study. Blood. 1960 Mar;15:350-9. link to original article contains dosing details in manuscript PubMed

PATCO

PATCO: Prednisone, Ara-C (Cytarabine), Thioguanine, Cyclophosphamide, Oncovin (Vincristine)

Regimen

Study Years of enrollment Evidence
Chard et al. 1978 (CCG 102) NR in abstract Non-randomized

Glucocorticoid therapy

Chemotherapy

References

  1. CCG 102: Chard RL Jr, Finklestein JZ, Sonley MJ, Nesbit M, McCreadie S, Weiner J, Sather H, Hammond GD. Increased survival in childhood acute nonlymphocytic leukemia after treatment with prednisone, cytosine arabinoside, 6-thioguanine, cyclophosphamide, and oncovin (PATCO) combination chemotherapy. Med Pediatr Oncol. 1978;4(3):263-73. link to original article PubMed
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