Comparison of Consolidation Strategies for Pediatric Patients With Acute Myeloid Leukemia: Results of the Randomized GATLA 8-LMA-P’07 Trial
Bibliographic record
Abstract
OBJECTIVE: The primary objective was to determine whether consolidation (CONS) with 2 short chemotherapy cycles using cytarabine plus idarubicin and high dose cytarabine plus mitoxantrone (2-cycle) reduced the cumulative incidence of relapse compared with the standard regimen of a 6-week CONS phase among newly diagnosed pediatric patients with acute myeloid leukemia (AML). PATIENTS AND METHODS: GATLA 8-LMA-P'07 was a phase 3 trial conducted in 26 centers in Argentina. We included newly diagnosed pediatric patients with AML 0 to 18 years of age. Patients with M3 AML were excluded. After 2 cycles of induction, patients in remission were randomized to either CONS or 2-cycle CONS chemotherapy. High-risk patients received matched family stem cell transplantation or maintenance therapy for 12 months. RESULTS: One hundred seven patients younger than 18 years with de novo AML were randomized to CONS (n = 52) or 2-cycle (n = 57). Cumulative incidence (SE) of relapse was not significantly different between CONS (31% [0.1]) and 2-cycle (39% [0.1]) CONS ( P = 0.25). There was no significant difference in 5-year event-free survival (53.6% [0.8] vs 44.3 [0.7], P = 0.31) or 5-year overall survival (55.0% [0.8] vs 53.7% [0.7], P = 0.91) for CONS and 2-cycle CONS respectively. CONCLUSIONS: CONS with 2 cycles of chemotherapy was not significantly better than the standard CONS in reducing the cumulative risk of relapse among newly diagnosed children with AML from Argentina. Future research should evaluate new approaches to improve outcomes for pediatric patients with AML.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".