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Myeloid sarcoma is associated with poor clinical outcome in pediatric patients with acute myeloid leukemia.

Authors :
Xu, Lu-Hong
Wang, Yin
Chen, Zhi-Yuan
Fang, Jian-Pei
Source :
Journal of Cancer Research & Clinical Oncology. Apr2020, Vol. 146 Issue 4, p1011-1020. 10p.
Publication Year :
2020

Abstract

Purpose: The impact of myeloid sarcoma (MS) on clinical outcome of pediatric acute myeloid leukemia (AML) patients remains controversial. Moreover, little is known about the role of stem cell transplantation (SCT) in such patients. Methods: Clinical data of patients with AML under 18 years of age were retrieved from the TARGET dataset. We analyzed the prevalence, clinical profile, molecular characteristics, and prognosis of MS in these patients. Results: Among 884 pediatric patients with AML, the frequency of MS was 12.3%. Pediatric AML with MS was associated with age under 1-year, abnormal cytogenetics, and KMT2A rearrangement. Moreover, MS was associated with a low complete remission rate, high induction death, poor 5-year EFS, and OS. KMT2A rearrangement had a negative impact on clinical outcome in AML patients with MS. In addition, SCT had no significant effect on the survival of AML patients with MS. Multivariate analysis revealed that MS was an unfavorable prognostic factor in pediatric AML in terms of EFS (Hazard ratio 1.670, P < 0.001) and OS (Hazard ratio 1.623, P = 0.004). Conclusions: The presence of MS at diagnosis of pediatric AML is associated with poor clinical outcomes, particularly when associated with KMT2A rearrangements. Moreover, pediatric patients with AML and MS may not benefit from SCT. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01715216
Volume :
146
Issue :
4
Database :
Academic Search Index
Journal :
Journal of Cancer Research & Clinical Oncology
Publication Type :
Academic Journal
Accession number :
142371320
Full Text :
https://doi.org/10.1007/s00432-020-03128-7