Patients aged less than 3 years with acute myeloid leukaemia characterize a molecularly and clinically distinct subgroup.
Yusuke HaraNorio ShibaGenki YamatoKentaro OhkiKen TabuchiManabu SotomatsuDaisuke TomizawaAkitoshi KinoshitaHirokazu ArakawaAkiko M SaitoNobutaka KiyokawaAkio TawaKeizo HoribeTakashi TagaSouichi AdachiTomohiko TakiYasuhide HayashiPublished in: British journal of haematology (2019)
Although infants (age <1 year) with acute myeloid leukaemia (AML) have unique characteristics and are vulnerable to chemotherapy, children aged 1-2 years with AML may have characteristics similar to that of infants. Thus, we analysed 723 paediatric AML patients treated on the Japanese AML99 and AML-05 trials to identify characteristics of younger children. We identified patients aged <3 years (the younger group) as a distinct subgroup. KMT2A-rearrangement (KMT2A-R), CBFA2T3-GLIS2, CBFB-MYH11 and NUP98-KDM5A were frequently found in the younger group. Prognostic analyses revealed poor 5-year overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse (CIR) in patients with CBFA2T3-GLIS2 (42%, 17% and 83%, respectively) and those with NUP98-KDM5A (33%, 17% and 83%, respectively). Additionally, we identified KMT2A-R and CBFB-MYH11 as age-specific prognostic markers. Regarding KMT2A-R, the younger group had significantly better OS, EFS and CIR than the older group (aged 3 to <18 years) (P = 0·023, 0·011 and <0·001, respectively). Conversely, concerning CBFB-MYH11, the younger group had significantly poor EFS and CIR than the older group (each P < 0·001), suggesting that certain molecular markers are linked to different prognoses according to age. Therefore, we characterized patients <3 years as a distinct subgroup of paediatric AML.
Keyphrases
- acute myeloid leukemia
- end stage renal disease
- ejection fraction
- chronic kidney disease
- newly diagnosed
- prognostic factors
- intensive care unit
- emergency department
- young adults
- peritoneal dialysis
- allogeneic hematopoietic stem cell transplantation
- randomized controlled trial
- dendritic cells
- liver failure
- radiation therapy
- risk factors
- acute lymphoblastic leukemia
- drug induced
- single molecule
- community dwelling
- extracorporeal membrane oxygenation
- chemotherapy induced