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Toxicity and outcome of children with treatment related acute myeloid leukemia
Author(s) -
Tabori Uri,
Revach Giselle,
Nathan Paul C.,
Strahm Brigitte,
Rachlis Alisa,
Shago Mary,
Grant Ronald,
Doyle John,
Malkin David
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21157
Subject(s) - medicine , myeloid leukemia , hematopoietic stem cell transplantation , adverse effect , population , toxicity , oncology , surgery , transplantation , environmental health
Background The aim of this study was to evaluate the clinical course and outcome of children with treatment related acute myeloid leukemia (tAML) and compare them to children with primary AML (pAML). Procedure We retrospectively reviewed the demographic, treatment, toxicity, and outcome data of children with tAML and treatment related myelodysplastic syndrome (tMDS), treated at our institution between 1975 and 2005. We compared these parameters with matched controlled children with pAML. Finally we compared overall survival (OS) for tAML with all pAML children treated at the study era in our institution. Results Twenty‐one patients with tAML (n = 19) and tMDS (n = 2) were identified. Three years event‐free survival (EFS) and OS were both 14 ± 8%. Compared to pAML patients, tAML had a higher rate of adverse cytogenetics ( P < 0.008) and inferior OS ( P = 0.027) but no significant difference in treatment toxicity or death. All survivors were treated with allogeneic hematopoietic stem cell transplantation (HSCT). Conclusions In this population based report of pediatric tAML, outcome was poor and was related to a higher probability of poor cytogenetic features rather than excessive toxicities or inability to deliver therapy. HSCT should be considered for patients with tAML. These preliminary findings should set the stage for prospective cooperative studies. Pediatr Blood Cancer 2008;50:17–23. © 2007 Wiley‐Liss, Inc.