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Improvement of treatment outcome over 2 decades in children with acute myeloid leukemia
Blood Research ; : 25-34, 2018.
Article in English | WPRIM | ID: wpr-713632
ABSTRACT

BACKGROUND:

The prognosis of pediatric acute myeloid leukemia (AML) has recently improved. This study aimed to describe the epidemiology, changes in treatment strategies, and improvement of outcomes in Gwangju-Chonnam children with AML over 2 decades.

METHODS:

Medical records of 116 children with newly diagnosed AML were retrospectively reviewed for demographic characteristics, prognostic groups including cytogenetic risks, treatment protocols, and survival rates over the periods between 1996 and 2005 (Period I, N=53), and 2006 and 2015 (Period II, N=38).

RESULTS:

The annual incidence of AML has decreased with reduced pediatric population. The 5-year Kaplan-Meier (K-M) estimated overall survival (OS) and event-free survival (EFS) rates in 110 AML patients were 53.2±5.1% and 43.8±5.1%, respectively. The 5-year OS rate significantly improved during period II (70.3±7.0%) as compared to that during period I (40.0±6.8%) (P =0.001). The 5-year OS was not significantly different among cytogenetic risk groups (P =0.11). Fifty-eight patients underwent hematopoietic stem cell transplantation (HSCT). The K-M 5-year estimated survival for transplanted patients was 53.7±7.0%, while that for chemotherapy-only patients was 30.1±9.1% (P =0.014). Among the prognostic factors, treatment modality was the only independent factor. The chemotherapy-only group had a relative risk of 2.06 for death compared with the transplantation group (P=0.015).

CONCLUSION:

The survival of Korean children with AML has improved to a level comparable with that of developed countries over 2 decades, owing to a change in induction strategy, better supportive care with economic growth, refinement of HSCT techniques including a better selection of patients based on prognostic groups, and stem cell donor selection.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Stem Cells / Leukemia, Myeloid, Acute / Economic Development / Developed Countries / Clinical Protocols / Medical Records / Epidemiology / Incidence / Survival Rate Type of study: Etiology study / Practice guideline / Incidence study / Observational study / Prognostic study Limits: Child / Humans Language: English Journal: Blood Research Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Stem Cells / Leukemia, Myeloid, Acute / Economic Development / Developed Countries / Clinical Protocols / Medical Records / Epidemiology / Incidence / Survival Rate Type of study: Etiology study / Practice guideline / Incidence study / Observational study / Prognostic study Limits: Child / Humans Language: English Journal: Blood Research Year: 2018 Type: Article