Children with matched-related donors are assigned to allogeneic marrow transplant intensification. Transplant cytoreduction consists of age-adjusted busulfan and cyclophosphamide. The majority of children with AML Down syndrome can be cured of their leukemia. Mortality during induction due to bleeding complications is more common in this subtype than other FAB classifications. The presence of the PML-RARalpha transcript predicts response to retinoic acid.
Remission occurs via differentiation of blasts.
However, in a randomized trial of chemotherapy versus ATRA, there was no difference in the severe hemorrhagic complications between the groups. MRC Childhood Leukemia Working Party. Wells RJ, Woods WG, Buckley JD, et al. Treatment of newly diagnosed children and adolescents with acute myeloid leukemia. Brochstein JA, Kernan NA, Groshen S, et al.