1. Recent Advances in the Management of Pediatric Acute Myeloid Leukemia—Report of the Hungarian Pediatric Oncology-Hematology Group
- Author
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Gábor T. Kovács, Zsuzsanna Gaál, Réka Simon, Krisztián Kállay, Gergely Kriván, Bettina Kárai, István Szegedi, Csongor Kiss, Miklós Petrás, Anikó Ujfalusi, Zsuzsanna Jakab, and Agnes Kelemen
- Subjects
Acute promyelocytic leukemia ,Hungarian Pediatric Oncology-Hematology Group ,multidimensional flow cytometry ,Cancer Research ,medicine.medical_specialty ,Chemotherapy ,business.industry ,survival outcomes ,medicine.medical_treatment ,Pediatric acute myeloid leukemia ,Outcome measures ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Hematopoietic stem cell transplantation ,Treatment results ,acute myeloid leukemia ,acute promyelocytic leukemia ,medicine.disease ,Pediatric AML ,Article ,Oncology ,Internal medicine ,medicine ,Pediatric hematology ,business ,RC254-282 - Abstract
Simple Summary The outcome of pediatric AML improved considerably worldwide during the past few decades. Hereby, we summarize the therapeutic results of pediatric AML patients registered between 2012 and 2019 in Hungary. As compared to our previous results, improvement was registered in event-free (EFS) and overall (OS) survival, which can be attributed to the application of contemporary diagnostic and therapeutic guidelines, advanced supportation, and higher efficacy of hematopoietic stem cell transplantation. Between 2016 and 2019, a statistically significant increment of 2-year EFS was confirmed over the period between 2012 and 2015. The most prominent progress was observed in acute promyelocytic leukemia (APL). Multidimensional flow cytometry made possible the prompt introduction of ATRA in two cases with M3v, who also represent the first pediatric APL patients in Hungary to be treated with arsenic-trioxide. Besides joining multinational pediatric AML treatment groups, our future aims include the introduction of centralized treatment centers and diagnostic facilities. Abstract Outcome measures of pediatric acute myeloid leukemia (AML) improved considerably between 1990 and 2011 in Hungary. Since 2012, efforts of the Hungarian Pediatric Oncology-Hematology Group (HPOG) included the reduction in the number of treatment centers, contemporary diagnostic procedures, vigorous supportation, enhanced access to hematopoietic stem cell transplantation (HSCT), and to targeted therapies. The major aim of our study was to evaluate AML treatment results of HPOG between 2012 and 2019 with 92 new patients registered (52 males, 40 females, mean age 7.28 years). Two periods were distinguished: 2012–2015 and 2016–2019 (55 and 37 patients, respectively). During these periods, 2 y OS increased from 63.6% to 71.4% (p = 0.057), and the 2 y EFS increased significantly from 56.4% to 68.9% (p = 0.02). HSCT was performed in 37 patients (5 patients received a second HSCT). We demonstrate advances in the diagnosis and treatment of acute promyelocytic leukemia (APL) in two cases. Early diagnosis and follow-up were achieved by multidimensional flow cytometry and advanced molecular methods. Both patients were successfully treated with all-trans retinoic acid and arsenic-trioxide, in addition to chemotherapy. In order to meet international standards of pediatric AML management, HPOG will further centralize treatment centers and diagnostic facilities and join efforts with international study groups.
- Published
- 2021