Protocols - Hemorio
Protocols - Hemorio
Protocols - Hemorio
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BMP<br />
LMA IN CHILDREN AND TEENAGERS<br />
• Until 16-years-old Children protocol BFM 2004<br />
• After 17-years-old Adult protocol 7+3<br />
Protocol based on BFM 2004<br />
AML-BFM 2004<br />
(Special, modified version without randomisations for the Hospital Nino Jesus, Madrid, Spain)<br />
Day 1 15 21-28 42-56 88 ~112 ~140<br />
MRD MRD MRD MRD MRD MRD a MRD a<br />
Docum. Docum. Docum. Docum. Docum. Docum.<br />
AML-BFM 2004<br />
Induction 1 Induction 2<br />
AIE 1<br />
SR<br />
HR<br />
HAM<br />
1 Consider special rules for children with AML and Dow n’s syndrome/AM L FAB M3! a in patients with molecular marker<br />
2 1x /week for 4 weeks at the beginning of Maintenance Therapy<br />
3 only for children of the high-risk group<br />
A: ARA-C; cytarabine<br />
I: idarubicin<br />
E: etoposide-phosphate<br />
HA: high-dose cytarabine<br />
M: mitoxantrone<br />
AI 1<br />
The patients are divided in 2 risk groups:<br />
Consolidierung<br />
AI<br />
haM 1<br />
98<br />
haM<br />
Intensification<br />
HAE<br />
HAE<br />
SCT from HLA-identical<br />
siblings<br />
R<br />
12 Gy vs.<br />
18 Gy 1<br />
Maintenance Therapy 1 Year<br />
Cytarabine IT 1,2<br />
HAE: high-dose cytarabine/ etoposide-phosphate<br />
R: randomisation<br />
SR: standard-risk group<br />
HR: high-risk group<br />
MRD: minimal residual disease<br />
BMP: bone marrow puncture<br />
Docum.: obligatory documentation of the respective therapy course<br />
STANDARD RISK HIGH RISK<br />
M3<br />
LMA in Down Syndrome<br />
M1 / M2 with Auer Rods<br />
M4 eosinophilic<br />
LMA with t(8; 21) /<br />
Inv (16)<br />
INDICATION OF STEM CELL TRANSPLANT:<br />
MO on D 15 with > 5% blasts<br />
M0<br />
M1/ M2 without Auer Rods<br />
M4<br />
M5<br />
M6<br />
M7<br />
1. Donors related to all high risk patients in 1st remission<br />
2. Donors not related to all high risk patients with prolonged aplasia (over 4 weeks after HAM)<br />
without signs of medullar regeneration.<br />
Doses in infants:<br />
In infants (< 12 months or < 10 kg), doses are calculated by weight (kg) and not by body surface (with the<br />
exception of HD-ARA-C; see its own table). Doses in m 2 are divided by 30 to obtain doses in kg.
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