Preserved High Probability of Overall Survival with Significant Reduction of Chemotherapy for XXXX in Down Syndrome: A Nationwide Prospective Study in Japan.

@entity1 @entity295 @entity7765 @entity706 @entity2800 @entity2592 @entity2879 @entity1467
BACKGROUND: On the basis of results of previous Japanese trials for @entity2800 in @entity1467 (ML-DS), the efficacy of risk-oriented therapy was evaluated in the Japanese @entity706 Study Group AML-D05 study. PROCEDURE: All @entity1 received induction chemotherapy that consisted of @entity7765 , intermediate-dose @entity2592 , and @entity2879 . @entity1 who achieved complete remission (CR) after initial induction therapy were stratified to the standard risk (SR) group and received four courses of reduced-dose intensification therapy. @entity1 who did not achieve CR were stratified to the high risk (HR) group and received intensified therapy that consisted of continuous or high-dose @entity2592 . RESULTS: A total of 72 @entity1 were eligible and evaluated. One @entity1 died of @entity295 during initial induction therapy. Sixty-nine @entity1 were stratified to SR and two @entity1 to HR. No therapy-related deaths were observed during intensification therapy. The 3-year event-free and overall survival rates were 83.3%      4.4% and 87.5%      3.9 %, respectively. Age at diagnosis less than 2 years was a significant favorable prognostic factor for risk of relapse (P  =  0.009). CONCLUSIONS: The attempt of risk-oriented prospective study for ML-DS was unsuccessful, but despite the dose reduction of chemotherapeutic agents, the overall outcome was good, and further dose reduction might be possible for specific subgroups.
