Conclusions:
The analysis of our case cohort including eight pediatric patients leads
to the assumption that a salvage therapy with melphalan / cytarabine in
primary refractory or multiply-relapsed acute leukemia could be a
possible curative approach: We registered a complete or partial
remission in 63% of cases with the possibility to proceed to allogeneic
stem cell transplantation. It resulted in one year and three year
survival rates of 50% and 29%, respectively. Future multicentre
studies should be performed with higher patient numbers to verify these
results and to identify differences in the response rates between
various subgroups such as acute myeloid and acute lymphoblastic
leukemias.