Outcome of Acute Myeloid Leukemia in Children Adolescents and Young Adults Treated with an Uniform Protocol in Casablanca, Morocco

Abstract

Treatment of acute myeloblastic leukemia in children, adolescents and young adults (AYA) is a challenge in low-income countries. To evaluate treatment outcomes of children (B 15 years) and AYA (15-30 years) diagnosed with novo AML and treated in a single center according to the AML-MA 2011 protocol. From January 2011 to December 2015, eligible patients (age B 30 years) with novo AML had been enrolled on a uniform treatment protocol. The diagnosis was confirmed according to the FAB classification using the WHO 2008 criteria. Patients with WBC C 50 G/L had pretreated 4 days of hydroxyurea followed by two inductions and two consolidations. Supportive care consisted of transfusion of labile blood products, antibiotics and antifungals, and patient and family education by the hygiene team. 155 patients were recruited, 41 were \ 15 years old (22 boys, median age 7.8 years). Of the 114 AYA enrolled, (48 women, median age 23 years). Complete remission after two inductions was 28/41 (68.3%) of the children, including 100% of the children in the favorable group and 71/114 (62.3%) of the AYA, 22 of whom (68.7%) were in the favorable group. The number of deaths among children was 6 (14.6%). The evaluation of the AML-MA-2011 National Protocol in the age groups of children and AYA reveals that the objective of treatment is almost achieved in terms of complete remission in the two age groups.

Outcome of pediatric acute myeloid leukemia (AML) in low- and middle-income countries: a systematic review of the literature

“…Most studies (n=7) reported the 5-year pEFS, which varied from 24% to 63% [20,23,26,28,30,42,44]. One study reported a 7-year pEFS of 36% [39], and two other studies reported a 4-year pEFS of 30% and 28% [25,35]. In the study with a 4-year pEFS of 28%, the median EFS was reported to be 13 months [35].…”

“…Six studies [19,22,25,35,36,40] reported treatment outcomes of cytogenetic prognostic subgroups. In total, 130 favorable-risk, 51 intermediate-risk, and 19 adverse-risk patients were evaluated.…”

“…In total, 130 favorable-risk, 51 intermediate-risk, and 19 adverse-risk patients were evaluated. For favorable-risk AML, CR rates varied from 87% to 100% [19,25,36] and relapse rates from 20% to 57% [19,22,36]. Two studies reported a 4-year pEFS of 60% and 62% [25,35], one study reported a 3.5-year pEFS of 29% [36], and two studies reported a 2-year pEFS of 21% and 66% [19,40].…”

“…For favorable-risk AML, CR rates varied from 87% to 100% [19,25,36] and relapse rates from 20% to 57% [19,22,36]. Two studies reported a 4-year pEFS of 60% and 62% [25,35], one study reported a 3.5-year pEFS of 29% [36], and two studies reported a 2-year pEFS of 21% and 66% [19,40]. Concerning OS, two studies reported a 4-year pOS of 60% and 62% [25,35], one study reported a 3.5-year pOS of 29% [36], and one study reported a 2-year pOS of 41% [19].…”

“…Two studies reported a 4-year pEFS of 60% and 62% [25,35], one study reported a 3.5-year pEFS of 29% [36], and two studies reported a 2-year pEFS of 21% and 66% [19,40]. Concerning OS, two studies reported a 4-year pOS of 60% and 62% [25,35], one study reported a 3.5-year pOS of 29% [36], and one study reported a 2-year pOS of 41% [19]. For intermediate-risk AML, no CR rates were reported, and only one study reported a relapse rate of 38% [22].…”