Pediatric Acute Myeloid Leukemia Post Cytotoxic Therapy-Retrospective Analysis of the Patients Treated in Poland from 2005 to 2022

• Published in: Cancers 2023-01, Vol.15 (3), p.734
• Main Authors: Czogała, Małgorzata, Czogała, Wojciech, Pawińska-Wąsikowska, Katarzyna, Książek, Teofila, Bukowska-Strakova, Karolina, Sikorska-Fic, Barbara, Łaguna, Paweł, Skalska-Sadowska, Jolanta, Wachowiak, Jacek, Rodziewicz-Konarska, Anna, Moj-Hackemer, Małgorzata, Kałwak, Krzysztof, Muszyńska-Rosłan, Katarzyna, Krawczuk-Rybak, Maryna, Fałkowska, Anna, Drabko, Katarzyna, Kozłowska, Marta, Irga-Jaworska, Ninela, Bobeff, Katarzyna, Młynarski, Wojciech, Tomaszewska, Renata, Szczepański, Tomasz, Chodała-Grzywacz, Agnieszka, Karolczyk, Grażyna, Mycko, Katarzyna, Badowska, Wanda, Zielezińska, Karolina, Urasiński, Tomasz, Bartoszewicz, Natalia, Styczyński, Jan, Balwierz, Walentyna, Skoczeń, Szymon
• Format: Article
• Language: English
• Subjects: Acute lymphoblastic leukemia; Acute myeloid leukemia; Antimitotic agents; Antineoplastic agents; Bone cancer; Bone marrow; Brain cancer; Brain tumors; Cancer; Cancer therapies; Care and treatment; Chemotherapy; Children; Complications and side effects; Cytotoxicity; Disease; Ewings sarcoma; Families & family life; Latency; Leukemia; Lymphatic leukemia; Lymphoma; Lymphomas; Malignancy; Medical prognosis; Mutation; Neuroblastoma; Patient outcomes; Patients; Pediatric research; Pediatrics; Radiation therapy; Remission (Medicine); Risk factors; Stem cell transplantation; Stem cells; Transplantation; Tumors
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15030734

Acute P./myeloid leukemia post cytotoxic therapy (AML-pCT) is rare complication of cancer treatment in childhood. The objective of the study was to identify clinical characteristics and provide an analysis of the outcomes in pediatric AML-pCT. We retrospectively analyzed the data of 40 children with AML-pCT, treated from 2005 to 2020 within the Polish Pediatric Leukemia and Lymphoma Study Group. The most common primary malignancies were acute lymphoblastic leukemia (32.5%) and brain tumors (20%). The median latency period was 2.9 years (range: 0.7-12.9). Probabilities of overall (OS), event-free (EFS), and relapse-free survival (RFS) in the whole cohort were 0.49 ± 0.08, 0.43 ± 0.08, and 0.64 ± 0.10, respectively. Significant improvements in outcomes were observed in patients treated from 2015-2022 (two induction cycles followed by stem cell transplantation-SCT in 69% of patients) compared to 2005-2014 (four induction cycles followed by SCT in 49% of patients). The probability of EFS increased from 0.30 ± 0.10 to 0.67 ± 0.12 ( = 0.07) and RFS increased from 0.46 ± 0.11 to 1.0 ( = 0.01). The poorest outcome (OS and EFS 0.25 ± 0.20) was in AML post brain tumor, mainly due to deaths from toxicities. To conclude, treatment results achieved in patients with AML-pCT treated from 2015-2022, with two induction cycles followed by immediate SCT, were better than those reported by other authors, and comparable to the results in de novo AML.