Outcome of adolescent patients with acute myeloid leukemia treated with pediatric protocols

• Published in: International journal of hematology Vol. 102; no. 3; pp. 318 - 326
• Main Authors: Tomizawa, Daisuke, Watanabe, Tomoyuki, Hanada, Ryoji, Horibe, Keizo, Horikoshi, Yasuo, Iwamoto, Shotaro, Kinoshita, Akitoshi, Moritake, Hiroshi, Nakayama, Hideki, Shimada, Akira, Taga, Takashi, Takahashi, Hiroyuki, Tawa, Akio, Terui, Kiminori, Hori, Hiroki, Kawano, Yoshifumi, Kikuta, Atsushi, Manabe, Atsushi, Adachi, Souichi
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.09.2015; Springer Nature B.V
• Subjects: Adolescent; Adult; Age Factors; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Child; Child, Preschool; Disease-Free Survival; Female; Hematology; Humans; Infant; Infant, Newborn; Leukemia, Myeloid, Acute - drug therapy; Leukemia, Myeloid, Acute - mortality; Male; Medicine; Medicine & Public Health; Oncology; Original Article; Survival Rate; Adolescents; Acute myeloid leukemia; Children
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-015-1825-x

As past studies of adolescent and young adults (AYA) with acute myeloid leukemia (AML) reported conflicting results, we conducted a retrospective analysis using data from three Japanese pediatric AML studies. Among the 782 patients with de novo AML, 44 were classified as AYA (age ≥15 years at diagnosis), 164 as infants (0–1 year), 413 as younger children (2–11 years), and 161 as older children (12–14 years). While the 5-year event-free survival rate of AYA was not different among the groups, the five-year survival rate (54.7 %) was significantly lower than that of the other three groups ( P  = 0.019): 68.7 % for infants, 73.2 % for younger children, and 75.5 % for older children. No difference in the 5-year cumulative incidence of relapse was observed, but treatment-related death (TRD) of AYA was significantly higher (29.4 %) than that in infants (14.8 %), younger children (10.2 %), and older children (13.8 %). Multivariate analysis showed age ≥15 years old at diagnosis was associated with both poor survival rate and high TRD. Adolescents with AML had inferior survival due to a higher incidence of TRD, especially after failure of initial frontline treatment.