Blood Res.  2016 Dec;51(4):242-248. 10.5045/br.2016.51.4.242.

Therapy-related myeloid neoplasms in children and adolescents

• Cho HW
• Choi YB
• Yi ES
• Lee JW
• Sung KW
• Koo HH
• Yoo KH

• KMID: 2364314
• DOI: http://doi.org/10.5045/br.2016.51.4.242

Abstract

BACKGROUND
This retrospective study aimed to characterize and analyze the outcome of therapy-related myeloid neoplasms (t-MNs) in children and adolescents.
METHODS
The medical records of 16 patients under 21 years of age at the time of t-MN diagnosis were reviewed.
RESULTS
The median patient age was 11.5 years (range, 1.6-20.4 yr). Twelve patients had therapy-related acute myeloid leukemia, 3 patients had myelodysplastic syndrome, and 1 patient had chronic myelomonocytic leukemia. The median latency period was 29 months (range, 11-68 mo). Fourteen patients had cytogenetic aberrations, 8 of whom had an 11q23 abnormality. Of the 13 patients treated with curative intent, 12 patients received myeloid-type induction therapy that led to complete remission (CR) in 8 patients. Nine patients underwent allogeneic transplantation; 4 patients did not undergo transplantation due to chemotherapy-related toxic death (N=3) or parental refusal (N=1). The 5-year overall survival and event-free survival of the 13 patients treated with a curative intent were 46.2% and 30.8%, respectively. For the 9 patients who underwent allogeneic transplantation, the 5-year event-free survival was 66.7%.
CONCLUSION
A significant proportion of young patients with t-MNs can experience long-term survival, and allogeneic transplantation plays a key role for attaining cure in these patients.

Keyword

Therapy-related myeloid neoplasms; Pediatric population; Allogeneic hematopoietic stem cell transplantation

MeSH Terms

Adolescent*
Child*
Chromosome Aberrations
Diagnosis
Disease-Free Survival
Humans
Latency Period (Psychology)
Leukemia, Myeloid, Acute
Leukemia, Myelomonocytic, Chronic
Medical Records
Myelodysplastic Syndromes
Parents
Retrospective Studies
Transplantation, Homologous

Figure

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  Fig. 1 Overall survival (OS) and event-free survival (EFS) for 13 patients who were treated with a curative intent. The 5-year OS was 46.2%, and the 5-year EFS was 30.8%.

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  Fig. 2 Overall survival (OS) and event-free survival (EFS) for 9 patients who underwent allogeneic hematopoietic stem cell transplantation. The 5-year OS was 66.7% and the 5-year EFS was 66.7%.

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  Fig. 3 The event-free survival (EFS) after allogeneic hematopoietic stem cell transplantation in terms of disease status at the time of transplantation. The 5-year EFS rate was not significantly different between CR1/CR2 (N=5) and persistent disease status (N=4) (P=0.478).Abbreviations: CR1, complete remission 1; CR2, complete remission 2.

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