Premium
Outcome of children treated for relapsed acute myeloid leukemia in Central America
Author(s) -
Marjerrison Stacey,
Antillon Federico,
Bonilla Miguel,
Fu Ligia,
Martinez Roxana,
Valverde Patricia,
Vasquez Roberto,
Howard Scott C.,
Ribeiro Raul C.,
Sung Lillian
Publication year - 2014
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.24942
Subject(s) - medicine , blood cancer , myeloid leukemia , acute promyelocytic leukemia , overall survival , leukemia , population , pediatrics , cancer , surgery , retinoic acid , biochemistry , chemistry , environmental health , gene
Background Relapsed childhood acute myeloid leukemia (AML) outcomes have not been documented in resource‐limited settings. We examined survival after relapse for children with AML (non‐APML) and acute promyelocytic leukemia (APML) in Central America. Procedure We retrospectively evaluated outcomes of children with first relapse of AML (non‐APML) and APML in Guatemala, Honduras, or El Salvador diagnosed between 1997 and 2011. Predictors of subsequent event‐free survival (EFS) and overall survival (OS) were examined. Results We identified 140 children with relapsed AML (non‐APML), and 24 with relapsed APML. Two‐year subsequent EFS and OS (±SE) were 7.0 ± 2.5% and 9.1 ± 2.8%, respectively. Worse outcomes were associated with Hispanic or Indigenous heritage, white blood cell count at diagnosis ≥50 × 10 9 /L, and time to relapse <18 months. For those with relapsed APML, subsequent 2‐year EFS and OS were 36.7 ± 10.8% and 43.4 ± 12.1%, although few patients survived beyond 3 years. 15.2% of all patients were managed solely with palliative intent following first relapse. Conclusions Children with relapsed AML in Central America rarely survive, so palliative strategies should be considered following relapse in this population. However, children with late relapse or with APML may have a prolonged period of remission with second treatment, and consideration of re‐treatment may be appropriate. Pediatr Blood Cancer 2014;61:1222–1226. © 2014 Wiley Periodicals, Inc.