Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment–for health professionals (PDQ®)

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Changes to This Summary (01/28/2016)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Classification of Pediatric Myeloid Malignancies

Added text to state that outcomes for children with acute megakaryocytic leukemia (AMKL) vary between reported cooperative group trials, including the impact of t(1;22) on outcome. Also revised text to state that some studies have suggested that within the context of intensive chemotherapy and adequate supportive care, infants with t(1;22) can have a relatively favorable outcome that is superior to that of children with AMKL whose leukemia lacks t(1;22), with only 3 of 16 children with t(1;22) relapsing in two series; however, other studies have found the opposite in regard to outcome (cited Schweitzer et al. as reference 114).

Revised text about the CBFA2T3-GLIS2 fusion, including the incidence and outcome in acute myeloid leukemia (AML) patients.

Treatment Overview for AML

Added Schweitzer et al. as reference 40.

Postremission Therapy for AML

Added Locatelli et al. as reference 30.

Juvenile Myelomonocytic Leukemia

This section was extensively revised.

Chronic Myelogenous Leukemia (CML)

Added text to state that in an Italian study of 47 pediatric chronic-phase CML patients treated with 340 mg/m2 per day of imatinib, complete cytogenetic response was achieved in 91.5% of patients at a median time of 6 months, and the rate of major molecular response at 12 months was 66.6%. Thus, it appears that starting with the higher dose of 340 mg/m2 has superior efficacy and is typically tolerable, with dose adjustment as needed for toxicity (cited Giona et al. as reference 29).

Revised text to state that the question of whether a pediatric patient with CML should receive an allogeneic transplant when multiple tyrosine kinase inhibitors are available remains unanswered; however, recent reports suggest that progression-free survival does not improve when utilizing hematopoietic stem cell transplantation, compared with the sustained use of imatinib.

This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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