Dataset Information

Prognostic stratification of molecularly and clinically distinct subgroup in children with acute monocytic leukemia.

ABSTRACT:

Background

The prognosis of children with acute monocytic leukemia (AML-M5) remains unsatisfactory and the risk profile is still controversial. We aim to investigate the prognostic value of clinical and cytogenetic features and propose a new risk stratification in AML-M5 children.

Methods

We included 132 children with AML-M5. Overall survival (OS) and progression-free survival (PFS) were documented. Cox regression was performed to evaluate the potential risk factors of prognosis.

Results

The 5-year-OS was 46.0% (95% confidence intervals, 41.6%-50.4%) in all patients. There was significantly lower OS in the age ≤ 3 years old (P = .009) and hyperleukocytosis (P < .001). The FMS-like tyrosine kinase 3 (FLT3)-internal tandem duplication (ITD) and MLL-rearrangement carriers were associated with fewer survivors in all patients (37.1% and 36.7%) and chemotherapy-only group (19.0% and 35.0%). Notably, the number of survivor with MLL-rearrangement did not increase in hematopoietic stem cell transplant (HSCT) group. According to the Cox regression analysis, HSCT was a significantly favorable factor (P = .001), while hyperleukocytosis, age ≤ 3 years old, and BM blast ≥ 70% adversely affected the OS in all patients (all P < .05). Additionally, FLT3-ITD was a risk factor for OS in the chemotherapy-only group (P = .023), while hyperleukocytosis and age ≤ 3 years independently contributed to poor PFS (both P < .05). In comparison to the standard-risk group, significant poorer outcome was found in the high-risk group (both P < .005).

Conclusions

We propose that AML-M5 children with any of MLL-rearrangement, FLT3-ITD, hyperleukocytosis, BM blast ≥ 70%, or age ≤ 3 years old are classified into the high-risk group, and HSCT is beneficial especially in patients with FLT3-ITD mutation, hyperleukocytosis, and age ≤ 3 years old. Importantly, the choice of HSCT should be made more carefully in children with MLL-rearrangement for its suboptimal performance.

SUBMITTER: Liu LP

PROVIDER: S-EPMC7286455 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

Prognostic stratification of molecularly and clinically distinct subgroup in children with acute monocytic leukemia.

Liu Li-Peng LP Zhang Ao-Li AL Ruan Min M Chang Li-Xian LX Liu Fang F Chen Xia X Qi Ben-Quan BQ Zhang Li L Zou Yao Y Chen Yu-Mei YM Chen Xiao-Juan XJ Yang Wen-Yu WY Guo Ye Y Zhu Xiao-Fan XF

Cancer medicine 20200326 11

<h4>Background</h4>The prognosis of children with acute monocytic leukemia (AML-M5) remains unsatisfactory and the risk profile is still controversial. We aim to investigate the prognostic value of clinical and cytogenetic features and propose a new risk stratification in AML-M5 children.<h4>Methods</h4>We included 132 children with AML-M5. Overall survival (OS) and progression-free survival (PFS) were documented. Cox regression was performed to evaluate the potential risk factors of prognosis.< ...[more]

PMID: 32216042

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Dataset Information

Prognostic stratification of molecularly and clinically distinct subgroup in children with acute monocytic leukemia.

Background

Methods

Results

Conclusions

Publications

Prognostic stratification of molecularly and clinically distinct subgroup in children with acute monocytic leukemia.

Similar Datasets

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