[Analysis of clinical outcomes of 63 children with acute monocytic leukemia].

Abstract

OBJECTIVE:

To evaluate the outcomes of childhood acute monocytic leukemia (AML-M5) and explore the indications of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for children with AML-M5.

METHOD:

Seventy-five AML-M5 patients and 201 non-AML-M5 AML patients were enrolled in this retrospective analysis. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier method and prognostic factors were evaluated by COX regression with SPSS.

RESULT:

(1) Twelve patients gave up treatment after confirmed diagnosis. Two patients died on the second day after chemotherapy. Of the 61 patients, 73.8% (45/61) achieved complete remission (CR) after two courses of chemotherapy. The 5-year EFS rate was 34.5% ± 6.8%. But of the 117 non-AML-M5/M3 AML patients, the 5-year EFS rate was 51.0% ± 4.9%. (2) Multivariate analysis showed that age ≥ 10 y, the proportion of bone marrow blast cell counts ≥ 15% after the first induction therapy, not CR after two courses of chemotherapy were risk factors for the long-term prognosis. (3) Of the 20 patients whose bone marrow blast cell counts ≥ 15% after the first induction therapy, 5 patients who choose allo-HSCT had a better OS than the other 15 patients who choose chemotherapy only (60.0% ± 21.9% vs. 7.3% ± 7.1%, P = 0.024).

CONCLUSION:

Children with AML-M5 had a poorer prognosis than the other AML patients; patients whose bone marrow blast cell counts ≥ 15% after the first induction therapy chose allo-HSCT had a better prognosis. At present, there is no enough evidence to support that patients whose bone marrow blast cell counts < 15% after the first induction therapy should choose unrelated donor for allo-HSCT.

• Authors: Ying-Yong Xu, Jing Chen, Hui-Liang Xue, Jing-Yan Tang, Ci Pan, Hua Jiang, Qi-Dong Ye, Chang-Ying Luo, Min Zhou, Long-Jun Gu
• Journal: Zhonghua er ke za zhi = Chinese journal of pediatrics (Zhonghua Er Ke Za Zhi) Vol. 49 Issue 3 Pg. 175-80 (Mar 2011) ISSN: 0578-1310 [Print] China
• PMID: 21575364 (Publication Type: English Abstract, Journal Article)

Topics

• Adolescent
• Child
• Child, Preschool
• Disease-Free Survival
• Female
• Hematopoietic Stem Cell Transplantation
• Humans
• Infant
• Leukemia, Monocytic, Acute (surgery)
• Male
• Prognosis
• Retrospective Studies
• Treatment Outcome