Contributions
Abstract: PB1694
Type: Publication Only
Background
Western hospitals have achieved First Complete Remission (CR-1) and Overall Survival (OS) rates of 90% and 60% for children with Acute Myeloid Leukemia (AML). Intensified regimens of standard chemotherapy along with precise risk classification and improvements in supportive care are mainly attributed to this achievement.
Aims
We analyzed clinical data of our pediatric AML patients treated at KFSH&RC from 2005 to 2015 in order to assess the outcome of our treatment efforts including Hematopoietic Stem Cell Transplantation (HSCT).
Methods
A total of 155 pediatric patients with AML were registered at our institution from 2005 to 2015. 55.5% (86) were boys with a F:M ratio 1:1.2 and median age at diagnosis 5.5 years (Min: 1.3months, Max: 13.8 years). 12 patients were excluded from further analysis for not being able to complete induction at our institution. 7% (10 of 143) had Down ’s syndrome, 7.7% (11 of 143) had concomitant malignancies. 85.7% (120 of 140) were CNS-1, 27.4% (20 of 73) had MLL Gene rearrangement, 21.2% (14 of 66) were positive for TEL AML/RUNX1/RUNX1T1 and 22% (13 of 59) had PML/RAR (+). Trisomy 4, 10 or 17 was not seen among any of 13 patients tested. Most commonly observed FAB classification was M-5 (23.5%, 24 of 102) followed by M-2 (18.6%). 27.3% (39) were Low Risk, 43.4% (62) Intermediate and 29.4%(42) High Risk. 43.3% (58 of 134) received HSCT.
Results
Our CR-1 rate was 93.7% (134 of 143) with 100% in Low Risk, 95.2% Intermediate Risk and 85.7% in High Risk patients (P-Value: 0.023), requiring 1-3 cycles of chemotherapy with a median time of 1.3 months. Treatment Failure was observed in 6.3% (9 of 143). Relapse rates was 38.8%(52 of 134). Most common site of relapse was bone marrow (75%, 39 of 52). PML/RAR (P-Value: 0.044), Post-Induction BM Classification M-3 (P-Value: 0.034) and AML High Risk (P-Value: 0.003) were found to be significantly associated with Relapse. Age at diagnosis, or Time to CR-1 were not found to have any association with relapse. 51.9% (27 of 52) who relapsed, went for HSCT. With a median follow-up of 68.8 months, five year overall survival for our cohort of patients was (0.567±0.046); significantly poor (P-Value: 0.001) in relapsed (n=52, 0.137±0.051) compared to non-relapsed (n=82, 0.863±0.041); resulting in a five year event free survival of 0.472±0.044. Among relapsed group (n=52), five year overall survival was significantly better (0.160±0.073) for those who received HSCT (27) than who did not (n=25, 0.114±0.073, P-Value: 0.029). Five year overall survival was also significantly better for Non-Relapse group (n=31, 0.828±0.070) compared to relapsed patients (n=27, 0.160±0.073, P-Value = 0.001) for whom HSCT was administered (n=58)
Conclusion
The results of our treatment efforts are in conformity with the western literature. Precise risk classification can be a vital predictor in planning for first line and salvage therapies including HSCT for pediatric patients with AML.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Relapsed acute myeloid leukemia, Outcome, Acute Myeloid Leukemia
Abstract: PB1694
Type: Publication Only
Background
Western hospitals have achieved First Complete Remission (CR-1) and Overall Survival (OS) rates of 90% and 60% for children with Acute Myeloid Leukemia (AML). Intensified regimens of standard chemotherapy along with precise risk classification and improvements in supportive care are mainly attributed to this achievement.
Aims
We analyzed clinical data of our pediatric AML patients treated at KFSH&RC from 2005 to 2015 in order to assess the outcome of our treatment efforts including Hematopoietic Stem Cell Transplantation (HSCT).
Methods
A total of 155 pediatric patients with AML were registered at our institution from 2005 to 2015. 55.5% (86) were boys with a F:M ratio 1:1.2 and median age at diagnosis 5.5 years (Min: 1.3months, Max: 13.8 years). 12 patients were excluded from further analysis for not being able to complete induction at our institution. 7% (10 of 143) had Down ’s syndrome, 7.7% (11 of 143) had concomitant malignancies. 85.7% (120 of 140) were CNS-1, 27.4% (20 of 73) had MLL Gene rearrangement, 21.2% (14 of 66) were positive for TEL AML/RUNX1/RUNX1T1 and 22% (13 of 59) had PML/RAR (+). Trisomy 4, 10 or 17 was not seen among any of 13 patients tested. Most commonly observed FAB classification was M-5 (23.5%, 24 of 102) followed by M-2 (18.6%). 27.3% (39) were Low Risk, 43.4% (62) Intermediate and 29.4%(42) High Risk. 43.3% (58 of 134) received HSCT.
Results
Our CR-1 rate was 93.7% (134 of 143) with 100% in Low Risk, 95.2% Intermediate Risk and 85.7% in High Risk patients (P-Value: 0.023), requiring 1-3 cycles of chemotherapy with a median time of 1.3 months. Treatment Failure was observed in 6.3% (9 of 143). Relapse rates was 38.8%(52 of 134). Most common site of relapse was bone marrow (75%, 39 of 52). PML/RAR (P-Value: 0.044), Post-Induction BM Classification M-3 (P-Value: 0.034) and AML High Risk (P-Value: 0.003) were found to be significantly associated with Relapse. Age at diagnosis, or Time to CR-1 were not found to have any association with relapse. 51.9% (27 of 52) who relapsed, went for HSCT. With a median follow-up of 68.8 months, five year overall survival for our cohort of patients was (0.567±0.046); significantly poor (P-Value: 0.001) in relapsed (n=52, 0.137±0.051) compared to non-relapsed (n=82, 0.863±0.041); resulting in a five year event free survival of 0.472±0.044. Among relapsed group (n=52), five year overall survival was significantly better (0.160±0.073) for those who received HSCT (27) than who did not (n=25, 0.114±0.073, P-Value: 0.029). Five year overall survival was also significantly better for Non-Relapse group (n=31, 0.828±0.070) compared to relapsed patients (n=27, 0.160±0.073, P-Value = 0.001) for whom HSCT was administered (n=58)
Conclusion
The results of our treatment efforts are in conformity with the western literature. Precise risk classification can be a vital predictor in planning for first line and salvage therapies including HSCT for pediatric patients with AML.
Session topic: 4. Acute myeloid leukemia - Clinical
Keyword(s): Relapsed acute myeloid leukemia, Outcome, Acute Myeloid Leukemia