title: Prognostic factors in children with acute myeloid leukaemia and excellent response to remission induction therapy.
abstract: Minimal residual disease (MRD) is a strong prognostic factor in children and adolescents with acute myeloid leukaemia (AML) but nearly one-quarter of patients who achieve MRD-negative status still relapse. The adverse prognostic factors among MRD-negative patients remain unknown. We analysed the AML02 study cohort to identify demographic and genetic prognostic factors. Among the presenting features, certain 11q23 abnormalities, such as t(6;11) and t(10;11), acute megakaryoblastic leukaemia without the t(1;22), and age ≥10 years were associated with inferior outcome in patients who had MRD-negative status after either remission induction I or II. By contrast, those with rearrangement of CBF genes had superior outcome. Our study identifies patient populations for whom close post-remission MRD monitoring to detect and treat emerging relapse and adjustment in treatment intensity might be indicated.
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Seth E
authors.initials: SE
authors.lastname: Karol
authors.forename: Elaine
authors.initials: E
authors.lastname: Coustan-Smith
authors.forename: Xueyuan
authors.initials: X
authors.lastname: Cao
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Shurtleff
authors.forename: Susana C
authors.initials: SC
authors.lastname: Raimondi
authors.forename: John K
authors.initials: JK
authors.lastname: Choi
authors.forename: Raul C
authors.initials: RC
authors.lastname: Ribeiro
authors.forename: Gary V
authors.initials: GV
authors.lastname: Dahl
authors.forename: William Paul
authors.initials: WP
authors.lastname: Bowman
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Taub
authors.forename: Barbara
authors.initials: B
authors.lastname: Degar
authors.forename: Wing
authors.initials: W
authors.lastname: Leung
authors.forename: James R
authors.initials: JR
authors.lastname: Downing
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Rubnitz
authors.forename: Dario
authors.initials: D
authors.lastname: Campana
authors.forename: Hiroto
authors.initials: H
authors.lastname: Inaba
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D006801:Humans; D059785:Karyotype; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality; D018365:Neoplasm, Residual / Q000175:diagnosis; D011379:Prognosis; D012074:Remission Induction; D016896:Treatment Outcome; D051941:fms-Like Tyrosine Kinase 3 / Q000235:genetics
chemical_list: C497970:FLT3 protein, human; D051941:fms-Like Tyrosine Kinase 3
keywords: acute myeloid leukaemia; minimal residual disease; paediatric; prognostic factor