title: Outcome of adolescent patients with acute myeloid leukemia treated with pediatric protocols.
abstract: As past studies of adolescent and young adults (AYA) with acute myeloid leukemia (AML) reported conflicting results, we conducted a retrospective analysis using data from three Japanese pediatric AML studies. Among the 782 patients with de novo AML, 44 were classified as AYA (age ≥15 years at diagnosis), 164 as infants (0-1 year), 413 as younger children (2-11 years), and 161 as older children (12-14 years). While the 5-year event-free survival rate of AYA was not different among the groups, the five-year survival rate (54.7 %) was significantly lower than that of the other three groups (P = 0.019): 68.7 % for infants, 73.2 % for younger children, and 75.5 % for older children. No difference in the 5-year cumulative incidence of relapse was observed, but treatment-related death (TRD) of AYA was significantly higher (29.4 %) than that in infants (14.8 %), younger children (10.2 %), and older children (13.8 %). Multivariate analysis showed age ≥15 years old at diagnosis was associated with both poor survival rate and high TRD. Adolescents with AML had inferior survival due to a higher incidence of TRD, especially after failure of initial frontline treatment.
authors.affiliation: Division of Leukemia and Lymphoma, Children's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan, tomizawa-d@ncchd.go.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tomizawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Ryoji
authors.initials: R
authors.lastname: Hanada
authors.forename: Keizo
authors.initials: K
authors.lastname: Horibe
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Horikoshi
authors.forename: Shotaro
authors.initials: S
authors.lastname: Iwamoto
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Kinoshita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moritake
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakayama
authors.forename: Akira
authors.initials: A
authors.lastname: Shimada
authors.forename: Takashi
authors.initials: T
authors.lastname: Taga
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Akio
authors.initials: A
authors.lastname: Tawa
authors.forename: Kiminori
authors.initials: K
authors.lastname: Terui
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hori
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kikuta
authors.forename: Atsushi
authors.initials: A
authors.lastname: Manabe
authors.forename: Souichi
authors.initials: S
authors.lastname: Adachi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D015996:Survival Rate