title: Clinical characteristics and outcome of childhood de novo acute myeloid leukemia in Saudi Arabia: A multicenter SAPHOS leukemia group study.
abstract: Geographic variation and ethnicity have been implicated to influence the outcome of pediatric acute myeloid leukemia (AML). Furthermore, survival outcomes from developing countries are reported to be inferior to developed nations. We hypothesized that risk- and response-based outcome in high-income resource-rich developing countries would be comparable to developed nations as access to care and supportive measures would be similar. A total of 193 children diagnosed with de novo AML between January 2005 and December 2012 were identified, of those 175 were evaluable for outcome. Patients were stratified into low-risk (LR), intermediate-risk (IR), or high-risk (HR) groups. The complete remission (CR), early death, and induction failure rates were: 85.7%, 2.3%, and 12%; respectively. The 5-year cumulative incidences of relapse (CIR) and non-relapse mortality (NRM) were 43.1% and 9.8% respectively; overall survival (OS) was 58.8±4% and event-free survival (EFS) 40.9±4.1%. The 5-year OS for LR, IR, and HR groups were 72.0±6.9%, 59.8±6.2%, and 45.1±7.4%; respectively (p=0.003); and EFS 50.5±8.0%, 46.3±6.4%, and 23.3±6.4%; respectively (p=0.001). This study demonstrated comparable outcomes to those reported from developed countries. This suggests that utilization of risk- and response-based protocols in developing countries can overcome ethnic and geographic variation, if access to care and supportive measures were similar.
authors: Department of Pediatrics, Faculty of Medicine, Umm AlQura University, Makkah, Saudi Arabia; Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia. Electronic address: jastaniahwa@ngha.med.sa.
authors: Wasil
authors: W
authors: Jastaniah
authors: King Faisal Specialist Hospital & Research Center - Riyadh, Saudi Arabia; Assistant Professor, Faculty of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
authors: Ibrahim
authors: I
authors: Al Ghemlas
authors: King Fahad Specialist Hospital - Dammam, Saudi Arabia.
authors: Saad
authors: S
authors: Al Daama
authors: King Fahad Medical City - Riyadh, Saudi Arabia.
authors: Walid
authors: W
authors: Ballourah
authors: King Faisal Specialist Hospital & Research Center - Jeddah, Saudi Arabia.
authors: Mohammad
authors: M
authors: Bayoumy
authors: Prince Faisal Bin Bandar Cancer Center - Qaseem, Saudi Arabia.
authors: Faisal
authors: F
authors: Al-Anzi
authors: Prince Sultan Military Medical City - Riyadh, Saudi Arabia.
authors: Omar
authors: O
authors: Al Shareef
authors: Department of Pediatrics, College of Medicine, King Saud University - Riyadh, Saudi Arabia.
authors: Abdulrahman
authors: A
authors: Alsultan
authors: Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia.
authors: Mohammed Burhan
authors: MB
authors: Abrar
authors: Department of Pediatric Hematology/Oncology, King Abdullah specialized Children's Hospital, King Abdulaziz Medical City - Riyadh, Saudi Arabia.
authors: Reem
authors: R
authors: Al Sudairy
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D009026:Mortality; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D012074:Remission Induction; D018570:Risk Assessment; D012529:Saudi Arabia / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: AML; Acute leukemia; Developing; Ethnic; Response; Risk