Эпигенетическая терапия — важная составляющая в лечении детей, больных острым миелоидным лейкозом

,4 , V.S. Nemirovchenko 1 , L.G. Fetchina 5 , O.P. Hlebnikova 5 , L.J. Grivtsova 4 , 7 , E.V. Inyushkina 3 , E.G. Bojchenko 8 , 1 SUMMARY The results of pediatric AML are not good that is why we try to find new abilities of treatment besides knowing chemotherapy. We propose combination of epigenetic and chemotherapy is able to improve the treatment results in this group of patients. From 1991 to 2010 3 consecutive studies with 157 children enrolled were conducted, age 3 mo to 17 years, median age is 8.5 ± 0.39 years. In the protocol AML BFM 87 54 pts (m — 35 (64.8 %), f — 19 (35.2 %) were enrolled, in study NII DOG AML 2002 — 52 pts (m — 26 (51 %) and f — 25 (49 %). The protocol NII DOG AML 2007 was based on the combination of chemotherapy and epigenetic therapy consisting of valproic acid and all trans retinoic acid (ATRA). There were 52 pts were included in that study (m — 31 (59.6 %) and f — 21 (40.4 %). The remission rate was 43 (76.9 %) pts in protocol AML BFM 87, 43 (84.3 %) in protocol NII DOG AML 2002 and 48 (92.3 %) in protocol NII DOG AML 2007, p = 0.17. Complete remission achievement was higher in pts from high risk cohort who were treated by protocol NII DOG AML 2007 — 21 (91.3 %) than by AML BFM 87 — 9 (69.2 %) and NII DOG AML 2002 — 9 (74.2 %), p < 0.0001. Despite the absence of significant difference of EFS and DFS between pts stratified in different risk groups (EFS for standard, intermedium and high p = 0.8, p = 0.5 and p = 0.16; DFS p = 0.57, p = 0.4 and p = 0.19) EFS and DFS were higher in NII DOG AML 2007 study for all risk groups. Thus, the combination of chemotherapy with epigenetic drugs allows to achieve more complete remissions in intermedium and high risk groups of pts and higher survival. These results allow us to continue the study with histone deacetylating inhibitors and make a new protocol with