1 Introduction.- 1.1 Development of AML Therapy in Children.- 1.1.1 Historical Development.- 1.2 Prognostic Parameters in AML.- 1.3 Objectives of the Analysis.- 2 Patients and Therapy.- 2.1 Patient Eligibility.- 2.2 Therapy Schedule for Study AML-BFM-78.- 2.3 Therapy Schedule for Study AML-BFM-83.- 3 Definitions and Methods.- 3.1 Definitions.- 3.2 Diagnostic Methods.- 3.3 Statistical Methods.- 4 Results.- 4.1 Analysis of Pretherapeutic Patient Data.- 4.1.1 Total Group.- 4.1.2 FAB Subtypes.- 4.1.3 Morphologic and Laboratory Findings.- 4.2 Correlation of Initial Parameters Including Kinetics of Blast Cell Reduction.- 4.3 Outcome.- 4.4 Results by Morphologic Subtypes.- 4.5 Risk Factor Analysis of Pretherapeutic and o Response-Kinetic Parameters.- 4.5.1 Sex.- 4.5.1.1 Influence of Sex in the FAB Types.- 4.5.2 Age at Diagnosis.- 4.5.2.1 Influence of Age in the FAB Types.- 4.5.3 White Blood Cell and Blast Count.- 4.5.3.1 Influence of WBC on Prognosis in the FAB Types.- 4.5.3.2 Initial Blast Count.- 4.5.4 Initial CNS Involvement.- 4.5.5 Extramedullar Organ Involvement.- 4.5.6 Other Pretherapeutic Variables.- 4.5.6.1 Morphologic Variables: Auer Rods and Eosinophilia.- 4.5.6.2 Cytochemical, Immunological, Flow Cytometric, and Cytogenetic Findings.- 4.5.7 Parameters of Response Kinetics.- 4.5.7.1 Blast Reduction in the BM.- 4.5.7.2 Time Until CR.- 4.5.8 Prognostic Relevance of Pretherapeutic and Response-Kinetic Parameters: Cox Analyses.- 4.5.8.1 Results of AML-BFM-78 Study.- 4.5.8.2 Results of AML-BFM-83 Study.- 4.5.8.3 Results by FAB Group Allocation of AML-BFM-83 Study.- 4.5.8.4 Results by Individual FAB Types.- 4.5.8.5 Relationship Between the Implementation of Therapy and Pretherapeutic Prognostic Parameters.- 4.6 Early Death Due to Hemorrhage and/or Leukostasis and Other Complications.- 4.6.1 Early Death Due to Hemorrhage and/or Leukostasis.- 4.6.2 Early Death Due to Other Complications Within the First Six Weeks After Onset of Therapy.- 4.7 Analysis of the Implementation of Therapy in AML-BFM-83 Study.- 4.8 Toxicity During the Individual Therapy Phases of AML-BFM-83 Study.- 4.8.1 Complications During Induction.- 4.8.2 Complications During Consolidation.- 4.8.3 Complications During Maintenance.- 4.8.4 Summary of Lethal Complications.- 5 Discussion.- 5.1 Clinical and Morphologic Characteristics of Childhood AML.- 5.1.1 Epidemiological Factors.- 5.1.2 Clinical Data.- 5.2 Characterization of the FAB Types M1-M7 in Children by Pretherapeutic Parameters.- 5.3 Evaluation of the Relationship Between Pretherapeutic Parameters.- 5.4 Prognostic Relevance of Pretherapeutic Parameters and Response Kinetics: Definition of Prognostic Groups.- 5.4.1 Clinical Parameters.- 5.4.2 Morphologic Parameters.- 5.4.3 Cytogenetics.- 5.4.4 Response Kinetics.- 5.4.5 Prognostic Groups in Childhood AML.- 5.5 Influence of Therapy on the Prognostic Relevance of Pretherapeutic Parameters: Evaluating the Introduction of ADE Induction Therapy in AML-BFM-83 Study.- 5.6 Early Death Due to Hemorrhage and/or Leukostasis and Other Complications: Consequences for Initial Therapy.- 5.7 Relationship Between Implementation of Therapy, Complications, and Course.- 5.8 Perspectives for Future Prognosis-Adapted Therapy Strategies.- 5.8.1 Early Death Due to Hemorrhage and/or Leukostasis.- 5.8.2 Nonresponders.- 5.8.3 Relapses.- 5.8.4 Additional Chemotherapy.- 5.8.5 Allogeneic BMT in First CR.- 5.8.6 Autologous BMT.- 5.8.7 Measures for Reduction of Toxicity.- 5.8.8 Modification of the CNS Prophylaxis.- 5.8.9 Concluding Remarks.- 6 Summary.- 7 References.- 8 Appendix.- 9 Subject Index.
