Treatment Outcomes of Adolescents Compared to Younger Pediatric Patients with Acute Myeloid Leukemia: Do They Need a Special Approach?

被引：0

作者：

Pawinska-Wasikowska, Katarzyna ^{[1
,2
]}

Czogala, Malgorzata ^{[1
,2
]}

Bukowska-Strakova, Karolina ^{[3
]}

Surman, Marta ^{[3
]}

Rygielska, Monika ^{[4
]}

Ksiazek, Teofila ^{[5
]}

Sadowska, Beata ^{[6
]}

Pac, Agnieszka ^{[7
]}

Skalska-Sadowska, Jolanta ^{[8
]}

Samborska, Magdalena ^{[8
]}

Wachowiak, Jacek ^{[8
]}

Ciebiera, Malgorzata ^{[9
,10
]}

Chaber, Radoslaw ^{[9
,10
]}

Tomaszewska, Renata ^{[11
]}

Szczepanski, Tomasz ^{[11
]}

Zielezinska, Karolina ^{[12
]}

Urasinski, Tomasz ^{[12
]}

Moj-Hackemer, Malgorzata ^{[13
]}

Kalwak, Krzysztof ^{[13
]}

Kozlowska, Marta ^{[14
]}

Irga-Jaworska, Ninela ^{[14
]}

Sikorska-Fic, Barbara ^{[15
]}

Laguna, Pawel ^{[15
]}

Muszynska-Roslan, Katarzyna ^{[16
]}

Krawczuk-Rybak, Maryna ^{[16
]}

Falkowska, Anna ^{[17
]}

Drabko, Katarzyna ^{[17
]}

Bobeff, Katarzyna ^{[18
]}

Mlynarski, Wojciech ^{[18
]}

Chodala-Grzywacz, Agnieszka ^{[19
]}

Karolczyk, Grazyna ^{[19
]}

Mycko, Katarzyna ^{[20
]}

Badowska, Wanda ^{[20
]}

Bartoszewicz, Natalia ^{[21
]}

Styczynski, Jan ^{[21
]}

Machnik, Katarzyna ^{[22
]}

Mizia-Malarz, Agnieszka ^{[23
]}

Balwierz, Walentyna ^{[1
,2
]}

Skoczen, Szymon ^{[1
,2
]}

机构：

[1] Jagiellonian Univ Med Coll, Inst Pediat, Dept Pediat Oncol & Hematol, PL-30663 Krakow, Poland

[2] Univ Childrens Hosp, Dept Pediat Oncol & Hematol, PL-30663 Krakow, Poland

[3] Jagiellonian Univ Med Coll, Inst Pediat, Dept Clin Immunol, PL-30663 Krakow, Poland

[4] Univ Childrens Hosp, Dept Pediat Oncol & Hematol, Hematol Lab, PL-30663 Krakow, Poland

[5] Jagiellonian Univ Med Coll, Inst Pediat, Dept Med Genet, PL-30663 Krakow, Poland

[6] Univ Childrens Hosp, Dept Pediat Oncol & Hematol, Cytogenet & Mol Genet Lab, PL-30663 Krakow, Poland

[7] Jagiellonian Univ Med Coll, Fac Med, Dept Epidemiol & Prevent Med, PL-31034 Krakow, Poland

[8] Poznan Univ Med Sci, Dept Pediat Oncol Hematol & Transplantol, PL-60572 Poznan, Poland

[9] Clin Prov Hosp Rzeszow, Dept Pediat Oncohematol, PL-35301 Rzeszow, Poland

[10] Univ Rzeszow, Inst Med Sci, Med Coll, Dept Pediat, PL-35310 Rzeszow, Poland

[11] Med Univ Silesia, Dept Pediat Hematol & Oncol, PL-40055 Katowice, Poland

[12] Pomeranian Med Univ, Dept Pediat Hematooncol & Gastroenterol, PL-71252 Szczecin, Poland

[13] Wroclaw Med Univ, Clin Dept Pediat Bone Marrow Transplantat Oncol &, 213 Borowska St, PL-50556 Wroclaw, Poland

[14] Med Univ Gdansk, Dept Pediat Hematol & Oncol, PL-80210 Gdansk, Poland

[15] Med Univ Warsaw, Dept Oncol Pediat Hematol Transplantol & Pediat, PL-02091 Warsaw, Poland

[16] Med Univ Bialystok, Dept Pediat Oncol & Hematol, PL-15276 Bialystok, Poland

[17] Med Univ Lublin, Dept Pediat Hematol Oncol & Transplantol, PL-20090 Lublin, Poland

[18] Med Univ Lodz, Dept Pediat Oncol & Hematol, PL-91738 Lodz, Poland

[19] Reg Polyclin Hosp Kielce, Dept Pediat Hematol & Oncol, PL-25736 Kielce, Poland

[20] Prov Childrens Hosp, Dept Pediat & Hematol & Oncol, PL-10561 Olsztyn, Poland

[21] Nicolaus Copernicus Univ Torun, Dept Pediat Hematol & Oncol, Coll Med, PL-85094 Bydgoszcz, Poland

[22] City Hosp, Dept Pediat Hematol & Oncol, PL-41500 Chorzow, Poland

[23] Med Univ Silesia, Upper Silesia Childrens Care Hlth Ctr, Dept Pediat, PL-40752 Katowice, Poland

来源：

CANCERS | 2024年 / 16卷 / 06期

关键词：

acute myeloid leukemia; adolescents; young adults; children; treatment-related mortality; ACUTE LYMPHOBLASTIC-LEUKEMIA; ADULTS; AGE; CHILDHOOD; CHILDREN;

D O I：

10.3390/cancers16061145

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary The aim of this study was to retrospectively analyze the characteristics and treatment outcomes of adolescents with AML compared to children and infants treated, according to the two consecutive BFM protocols. It showed that overall survival did not differ significantly between adolescents and children aged 1 to 15 years. However, relapse-free survival was shorter in adolescents compared to younger children, and treatment-related mortality tended to be higher. High-risk genetics and a leukocyte count above 100,000/mu L at diagnosis, rather than age above 15 years, proved to be unfavorable prognostic factors for the treatment outcome.Abstract Background: The reports of studies that compare the survival of adolescents and young adults with younger children with acute myeloid leukemia (AML) are contradictory. Patients and Methods: We retrospectively analyzed 220 AML patients aged 0-18 years treated in pediatric oncologic centers in Poland from 2015 to 2022. The evaluated group included 31 infants (below 1 year), 91 younger children (1-9.9 years), 59 older children (10-14.9 years), and 39 adolescents (15-18 years). Results: A 5-year overall survival for adolescents was not significantly inferior compared to younger and older children (74.3 +/- 7.6% vs. 80.5 +/- 4.4% vs. 77.9 +/- 5.1, p = 0.243). However, relapse-free survival was lower in adolescents compared to younger children (76.5 +/- 7.8% vs. 65.7 +/- 9.0%, p = 0.049), and treatment-related mortality tended to be higher (10.3% vs. 4.4%, p = 0.569). In the univariate analysis, high-risk genetics [HR, 2.0 (95% CI 1.1-3.6; p = 0.014)] and a leukocyte count at diagnosis above 100,000/mu L [HR, 2.4 (95% CI 1.3-4.6; p = 0.004)] were found to be unfavorable prognostic factors for survival. Conclusions: Although we have not found that age over 15 years is an unfavorable factor for overall survival, the optimal approach to therapy in adolescents, as in other age groups, is to adjust the intensity of therapy to individual genetic risk and introduce targeted therapies when indicated.

引用

页数：14

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