Extramedullary infiltration at diagnosis and prognosis in children with acute myelogenous leukemia.

Abstract:

BACKGROUND:Extramedullary infiltration (EMI) is an occasional clinical symptom in childhood acute myelogenous leukemia (AML), but there is considerable controversy regarding the prognostic significance of EMI in AML. PROCEDURE:We evaluated the frequency and prognostic significance of EMI at diagnosis of AML in children. RESULTS:Of 240 cases of de novo AML excluding children with Down syndrome and acute promyelocytic leukemia, 56 (23.3%) showed EMI at diagnosis. Patients with EMI had a higher initial WBC count and a higher proportion of M4/M5 morphological variants. The complete remission rate following induction chemotherapy was lower in patients with EMI. However, the overall survival and event-free survival did not differ between patients with and without EMI. A detailed analysis showed that patients with EMI with a WBC count at diagnosis of over 100 x 10(9)/L or infiltration into the central nervous system are likely to have a poor prognosis. CONCLUSIONS:CNS leukemia and EMI together with a WBC count of >100 x 10(9)/L at diagnosis of AML are high risk factors for relapse, and alternative treatment approaches for patients with these characteristics should be explored.

journal_name

Pediatr Blood Cancer

journal_title

Pediatric blood & cancer

authors

Kobayashi R,Tawa A,Hanada R,Horibe K,Tsuchida M,Tsukimoto I,Japanese childhood AML cooperative study group.

doi

10.1002/pbc.20824

keywords:

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

393-8

issue

4

eissn

1545-5009

issn

1545-5017

journal_volume

48

pub_type

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