Efficacy Analysis of Comparison of CAMS (Chinese Academy of Medical Sciences)—2005 Trial and CAMS-2009 Trial for Pediatric Acute Myeloid Leukemia

We evaluated the outcome of 320 children with acute myeloid leukemia (AML) enrolled in the Chinese Academy of Medical Sciences (CAMS)-2005 trial and CAMS-2009 trial. Intensity of induction therapy was increased; consolidation therapy was stratified according to risk group and dose-dense intensive chemotherapy was adopted in CAMS-2009 trial. Hematopoietic stem cell transplantation (HSCT) was used in high-risk (HR) or relapsed children. There were 90 children enrolled in CAMS-2005 trial, and 230 children enrolled in CAMS-2009 trial. CR, early death, and induction failure rates of CAMS-2005 trial were 72.2%, 5.5% and 18.8%, while they were 83.8%, 4.9%, and 11.7% in CAMS-2009 trial (P=0.025, 0.775 and 0.120, respectively). Relapse occurred in 30.5% of patients achieving CR, relapse rates were 38.5% and 27.6% in CAMS-2005 trial and CAMS-2009 trial (P=0.104). The 5-year overall survival (OS) and event-free survival (EFS) were 60.4% and 52.3%. OS and EFS for CAMS-2005 trial and CAMS-2009 trial were 50.2%, 44.6% and 64.8%, 55.1% (P=0.041, 0.017, respectively). Increasing the intensity of induction therapy can improve the complete remission rate without increase of early death. Risk-stratified therapy and dose-dense intensive chemotherapy can improve the outcome of childhood AML.