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Long-term outcome of childhood acute myeloid leukemia: A 10-year retrospective cohort study
Tran Kiem Hao1, Chau Van Ha1, Nguyen Huu Son1
1Pediatric Center, Hue Central Hospital, Hue, Vietnam.
Insights
Childhood acute myeloid leukemia (AML) treatment improved survival rates and reduced abandonment at Hue Central Hospital. However, overall and event-free survival remain low, highlighting challenges in low-income countries.
Area of Science:
- Pediatric Hematology Oncology
- Clinical Research
- Public Health
Background:
- Childhood Acute Myeloid Leukemia (AML) is a critical pediatric malignancy.
- Historically, high abandonment rates and zero survival were observed at Hue Central Hospital.
- Significant improvements in social support strategies were implemented.
Purpose of the Study:
- To evaluate the long-term outcomes of childhood AML patients treated between 2010-2019.
- To assess the impact of modified treatment regimens and social support interventions.
- To identify challenges in pediatric AML management in resource-limited settings.
Main Methods:
- Retrospective analysis of 98 pediatric AML cases admitted from January 2010 to December 2019.
- Diagnosis confirmed via FAB criteria, cytochemistry, and immunophenotyping.
- Treatment utilized a modified AML 7-3 Regimen with comprehensive social support.
Main Results:
- An overall complete remission rate of 82.6% was achieved post-induction.
- Relapse occurred in 46.9% of patients; 3-year overall survival was 23.2%, and event-free survival was 20.2%.
- Abandonment rates decreased significantly to 4.1% due to holistic support strategies.
Conclusions:
- While remission rates are high, sustained survival for childhood AML remains a challenge in low- and middle-income countries.
- Holistic support strategies effectively reduced patient abandonment.
- Further improvements in treatment quality are necessary for better long-term outcomes in pediatric AML.
Abstract:
Acute Myeloid Leukemia (AML) in children is a serious disease. With a proper treatment, a long-term survival rate above 50% is typical. Before 2010, all the AML patients died in our hospital, and abandonment rate was more than 50%. The aims of this study are to explore the long-term outcome of newly childhood acute myeloid patients treated at Hue Central Hospital from 2010 to 2019.A retrospective study was conducted on 98 children with AML who admitted Hue Central Hospital from January 2010 to December 2019. The diagnosis was confirmed by morphological FAB criteria, cytochemistry and immunophenotype. Patients were treated with using modified AML 7-3 Regimen. Social supports were provided to patients/families. A total of 98 children with AML were analyzed with mean age of 5.6 years ranging from 3 months to 15 years. The male to female ratio was 1.8:1. The overall complete remission rate after induction were 82.6%). Patients accounted for 46 (46.9%) had relapses which occurred in during chemotherapy n=27 (27,6%), after finishing chemotherapy n=19(19,4%). Overall survival at 3 years were 23.2%. The event-free survival at 3 years were 20.2%o. Abandonment cases were 4 (4.1%). During the period study, abandonment has been reduced successfully with holistic strategies such as financial support, managing family group, providing education, early follow-up of patients who missed appointments and free accommodation near hospital for patients/families. However, with a high rate patient achieved complete remission after induction phase (82.6%), but the overal survival and event-free survival at 3 years were still low in my hospital (23.2 % and 20.2% respectively). It reflected that it was very difficult to treat successfully AML in lowand middle-income countries. We are considering the way how to improve the quality treatment for childhood acute myeloid leukemia in my hospital.
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