Therapeutic and Supportive Care Protocols Paving the Way to a Brighter Future for Children with AML: Children’s Oncology Group Experience (C217)

11:00 am – Noon Friday, September 14

coglogo1CNE  Acute leukemia is the most common malignancy in childhood and acute myeloid leukemia (AML) accounts for 15% of childhood leukemias. Survival for children with AML has improved, but overall survival is limited to 65%–70%. Improvement in survival for children with AML has been achieved by advances in knowledge contributed by various international cooperative group clinical trials. The majority of children newly diagnosed with AML in North America receive treatment on a Children’s Oncology Group (COG) clinical trial. The COG clinical trials for AML have investigated the role of risk stratification and intensification of therapy including the use of hematopoietic stem cell transplant. With the increase in intensity of chemotherapy, the COG recognized the limitations in delivering this therapy due to infection. Bacterial sepsis and invasive fungal infections are the leading cause of morbidity and treatment-related mortality in children receiving treatment for AML. To address this challenge, attempts to improve supportive care through COG’s Cancer Control trials have focused on prophylactic antibacterial and antifungal therapies.

This session will describe the results of recent AML therapeutic trials with a focus on improved risk stratification using cytogenetic and molecular diagnostics, use of minimal residual disease testing (MRD), and induction response that may contribute to improved outcomes in AML. In addition, results of recent supportive care trials and improved outcomes through decreasing the rate of infectious complications will be discussed. Due to the intensive nature of current AML therapy, the nursing care required for children undergoing treatment is complex and demands specialized knowledge and skill and a team-based approach to care. This session will enhance nursing practice by helping nurses to understand the most current AML therapeutic and supportive care protocols and the complex nursing care needs of their patients with AML.