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Toxicity and outcome of children with treatment related acute myeloid leukemia

Uri Tabori1, Giselle Revach, Paul C Nathan

  • 1Departments of Hematology Oncology and Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada.

Pediatric Blood & Cancer
|January 26, 2007
PubMed

Insights

Outcomes for pediatric treatment-related acute myeloid leukemia (tAML) are poor, with lower survival rates compared to primary AML. Poor cytogenetic features, not treatment toxicity, drive these outcomes, suggesting allogeneic hematopoietic stem cell transplantation (HSCT) is a viable option.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Cancer Research

Background:

  • Treatment-related acute myeloid leukemia (tAML) in children presents unique challenges.
  • Comparing tAML outcomes to primary AML (pAML) is crucial for understanding disease biology and treatment strategies.

Purpose of the Study:

  • To evaluate the clinical course and outcomes of pediatric tAML.
  • To compare the outcomes of tAML with those of pediatric pAML.

Main Methods:

  • Retrospective review of demographic, treatment, toxicity, and outcome data for children with tAML and treatment-related myelodysplastic syndrome (tMDS).
  • Comparison of tAML patients with matched pAML controls.
  • Analysis of overall survival (OS) for tAML versus all pAML patients.

Main Results:

  • Twenty-one patients (19 tAML, 2 tMDS) were identified.
  • Three-year event-free survival (EFS) and OS were 14%.
  • tAML patients exhibited higher rates of adverse cytogenetics and inferior OS compared to pAML, with no significant difference in treatment toxicity.

Conclusions:

  • Pediatric tAML has a poor prognosis, primarily due to adverse cytogenetic features.
  • Allogeneic hematopoietic stem cell transplantation (HSCT) is recommended for tAML survivors.
  • Further prospective cooperative studies are warranted to optimize tAML treatment.
Abstract

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