A MULTICENTER EXPERIENCE FROM LEBANON IN CHILDHOOD AND ADOLESCENT ACUTE MYELOID LEUKEMIA:HIGH RATE OF EARLY DEATH IN CHILDHOOD ACUTE PROMYELOCYTIC LEUKEMIA.

Roula Antoine Farah
  • Roula Antoine Farah
    St George Hospital University Medical Center, Beirut, lebanon, Lebanon | roula.fs@dm.net.lb

Abstract

 

Abstract

Background: Acute myeloid leukemia (AML) is a disease with marked heterogeneity. Despite major improvement in outcome, it remains a life-threatening malignancy. Demographic and clinical data on pediatric AML is lacking among the Lebanese population. Purpose: We aimed to identify clinical, molecular and outcome data in children with AML in Lebanon. Methods: A retrospective chart review of children with AML diagnosed in three Lebanese hospitals during the past 8 years was conducted. Results: From May 2002 through March 2010, we identified 24 children with AML in Saint George Hospital University Medical Center, University Medical Center Rizk Hospital and Abou-Jaoude Hospital. Males and females were equally represented; median age at diagnosis was 9 years (range 1-24) and median WBC at diagnosis was 31 x109/L (range: 2.1-376 x109/L). Twenty five percent of patients (6 out of 24) had acute promyelocytic leukemia (APL). Karyotype was normal in 33 % of patients; t(8;21), inv (16), t(8;9), t(7;11), t(9;11), complex chromosomal abnormality, monosomy 7 and trisomy 8 were the most common cytogenetic abnormalities encountered. Patients were treated on different European and North American protocols. Twelve patients (50%) achieved morphologic CR after cycle 1, 6 of them (50%) had bone marrow relapse within 11 months from diagnosis. Nine patients underwent allogeneic stem cell transplant and 3 of them are alive at 5 years post-transplant. Early death rate was 16.6% of patients, mainly those with APL and a presenting WBC > 10 x 109/L. Fifty per cent of APL patients had an early death due to DIC despite starting ATRA therapy. Overall, median survival for AML patients who died from disease progression was 25.8 months (range: 1-60 months). Overall disease-free survival was 30.4%. Patients < 10 years of age had a 50% survival rate compared to 0% in patients > 10 years. Conclusions:  Our report highlights the needs in Lebanon for better supportive care of children with APL including faster ATRA administration and aggressive transfusions, faster access to stem cell transplant for high-risk AML patients and the need for a national homogenous treatment strategy for children with AML.

 

Key-words: AML, pediatric AML, leukemia, AML Lebanon, APML, Early death

Keywords

AML, pediatric AML, leukemia, AML Lebanon, APL, APML, Early Death

Full Text:

PDF
HTML
Submitted: 2014-09-02 09:13:32
Published: 2014-12-27 00:00:00
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
721

Views:
PDF
329
HTML
6881

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2016 Mediterranean Journal of Hematology and Infectious Diseases

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

The Mediterranean Journal of Hematology and Infectious Diseases [eISSN 2035-3006] is owned by the U.C.S.C. and it is published by PAGEPress®, Pavia, Italy. All credits and honors to PKP for their OJS.
 
 
© PAGEPress 2008-2017     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185