Prognostic factors and outcome of recurrence in childhood acute myeloid leukemia.
BACKGROUND
Outcome after recurrence of childhood acute myeloid leukemia (AML) is poor. We performed this study to identify prognostic factors for recurrence and for survival after recurrence of AML.


METHODS
The clinical characteristics, biological features, treatment modalities, and outcomes of children with de novo AML who were enrolled on 3 consecutive clinical protocols from 1987 to 2002 at St. Jude Children's Research Hospital were studied. Regression modeling was used to identify prognostic factors for recurrence and for survival after recurrence.


RESULTS
The outcome after recurrence was poor, with a 5-year survival estimate of only 23.3% +/- 5.7%. Multivariable analysis indicated that male sex (P = .005), autologous stem cell transplant before recurrence (P = .097), each additional month from diagnosis to recurrence (P = .041), and stem cell transplant after recurrence (P < .001) were associated with a better survival after recurrence, whereas M5 or M7 morphology (P = .001) were significantly predictive of a lower survival estimate after recurrence.


CONCLUSIONS
Survival after recurrence was poor in children with AML. Novel therapies are urgently needed to prevent or to treat recurring AML.
Rubnitz
Jeffrey E
JE
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA. jeffrey.rubnitz@stjude.org
Razzouk
Bassem I
BI
Lensing
Shelly
S
Pounds
Stanley
S
Pui
Ching-Hon
CH
Ribeiro
Raul C
RC
D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007951:Leukemia, Myeloid / Q000401:mortality* / Q000473:pathology; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012008:Recurrence; D012737:Sex Factors; D033581:Stem Cell Transplantation; D015996:Survival Rate; D013997:Time Factors; D014182:Transplantation, Autologous