[Therapeutic results in acute myeloid leukemia in south Tunisia children [28 patients]]

We report the therapeutic results obtained in 28 children, aged less than 16 years, suffering from novo acute myeloid leukaemia [AML], collected and followed up during a period of 7 years [1996-2002]. Diagnosis and cytologic type were established according the Franco-Americano-British [FAB] cooperative group criteria. All of the patients received the same induction therapy, the so-called 7 + 3 regimen which associates aracytine for 7 days to an anthracyclin [daunorubicine or idarubicine] for three days. When a complete remission [CR] was obtained, a consolidation therapy was administered, consisting of two courses of aracytine associated to daunorubicin in the first course and to vepeside in the second one. Complete remission was obtained in 60 percent of the cases. Death rate during the induction phase was of 28 percent. Among the CR patients, 71 percent relapsed. Relapse was rapid [< 12 months] in 67 percent of the cases; it was medullary and neuro meningeal in two patients. Median survival, disease-free survival and event-free survival at 5 years were respectively of 35 percent, 11 percent and 13 percent. Event-free survival at 5 years was better in patients treated with high dose aracytine [20 percent] than in those treated with low dose [12 percent]. However, in the first [high dose] group, hematologic and extrahematologic toxicities were more important

[Contribution of RT-PCR for diagnosis of chronic myeloid leukemia]

The molecular analysis of chromosomal abnormalities associated with hematological malignancies allowed the identification of genes involved in theses rearrangements as well as of some recurrent mechanisms. Polymerase chain reaction [PCR] tools are now available to detect these rearrangements, allowing a better follow-up of these diseases. Chronic myeloid leukemia is a myeloproliferative disorder characterized by a reciprocal translocation t[9;22][q34;q11] which results in a bcr-abl fusion gene. Retro-transcription polymerase chain reaction [RT-PCR] is used to detect bcr-abl to establish diagnosis and to monitor patients. We report here the results of 30 patients samples tested in the hematology laboratory at Pasteur Institute, diagnosed as chronic myeloid leukemia and monitored with RT-PCR. Our results highlight the interest of molecular tools to diagnose and monitor patients mainly when cytogenetic techniques are irrelevant such as cases with complex chromosomal rearrangements or when patients achieve Philadelphia negativity after treatment