How I treat paediatric relapsed acute myeloid leukaemia

Area of Science:

• Pediatric Oncology
• Hematology
• Leukemia Research

Background:

• Paediatric acute myeloid leukaemia (AML) survival rates have improved, yet approximately one-third of patients experience relapse.
• Relapsed AML in children carries a poor prognosis, with limited long-term survival (around 35%) even with aggressive therapies like intensive chemotherapy and allogeneic stem cell transplantation.
• Current treatment regimens for relapsed paediatric AML are associated with significant toxicity and treatment-related mortality, highlighting the urgent need for therapeutic advancements.

Observation:

• Significant biological changes in AML cells can occur between initial diagnosis and relapse.
• Comprehensive diagnostic work-up is essential upon suspected relapse to identify these biological shifts.
• Practical challenges in managing relapsed paediatric AML require careful consideration.

Findings:

• The review synthesizes current knowledge on paediatric relapsed AML.
• It discusses various therapeutic possibilities and practical management issues.
• It emphasizes the need for improved treatment strategies to enhance survival rates.

Implications:

• Major improvements in treating paediatric relapsed AML are necessary.
• Understanding biological changes at relapse is key for tailored therapeutic approaches.
• This review provides insights for clinicians and translational researchers aiming to improve outcomes for children with relapsed AML.