Clinical characteristics and treatment outcome of pediatric patients with chronic myeloid leukemia

Belgaumi, Asim; Alshehri, Ali; Ayas, Mouhab; Al-Mahr, Mohammed; Al-Seraihy, Amal; Al-Ahmari, Ali; El-Solh, Hassan

doi:10.3324/haematol.2009.015180

Cited by 15 publications

(5 citation statements)

References 17 publications

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“…Both patients had splenomegaly which is the most prominent clinical feature of the disease, similar to that reported by Millot et al [1] and Belgaumi et al [16]. In as much as splenomegaly can occur in many other tropical diseases and as such is a non-specific indicator, its persistent presence in an adolescent should raise suspicion to investigate for CML more so as this disease is already noted to be common in this age group.…”

Section: Discussionsupporting

confidence: 85%

Paediatric Chronic Myeloid Leukaemia in a Tertiary Hospital in Nigeria: A Report of Two Cases

Patricia¹,

Ukamaka²,

Clifford³

et al. 2019

JPP

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Background: Chronic myeloid leukaemia (CML) is a myeloproliferative disorder with BCR/ABL mutation characterized by proliferation of granulocytic cell lines at varying stages of development. It is predominantly a disease of the adult population, only accounting for 2-3% of all childhood leukaemia. In our tertiary hospital, we recorded two cases of paediatric CML within three years. Objective: To increase the awareness of physicians on this seemingly rare form of childhood leukaemia. Case reports: We report a 10 year-old boy and a 16 year-old girl who presented to our facility with features suggestive of CML. Both cases had splenomegaly and leucocytosis. Cytogenetic assessment was positive for BCR-ABL in both cases. The first case was in chronic phase (CP) and had an initial therapy of hydroxyurea (HU) before referral for imatinib therapy. The second case received imatinib therapy, however due to blastic transformation to acute myeloid leukaemia (AML), she received treatment comprising of intravenous anthracycline and cytarabine. Conclusion: CML, although one of the rare childhood leukaemia is becoming increasingly noticed, probably due to availability of diagnostic facilities. There is therefore need for increased awareness of the disease among physicians to minimize delays in the diagnosis for improved care and better outcome.

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Section: Discussionsupporting

confidence: 85%

Paediatric Chronic Myeloid Leukaemia in a Tertiary Hospital in Nigeria: A Report of Two Cases

Patricia¹,

Ukamaka²,

Clifford³

et al. 2019

JPP

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“…In his Letter-to-the-Editor, Dr. Cheuk has raised concerns about the recommendations derived from our paper. 1 He compares the two relapsed patients in the SCT group with the one relapse in the IM group, stating that these data did not support our contention that a role for SCT as first-line therapy for CML needs to be maintained. Our small patient numbers and the very few episodes of disease failure do not allow us to detect any differences in the outcome for the two groups, and at most we can say that there is no significant relapse-free survival benefit for either treatment strategy.…”

mentioning

confidence: 74%

Clinical characteristics and treatment outcome of pediatric patients with chronic myeloid leukemia

Belgaumi¹,

Alshehri²

2010

Haematologica

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“…The number of publications regarding imatinib in childhood CML is limited. 6,[29][30][31][32][33][34] The Children's Oncology Group performed a phase I study of imatinib in 31 pediatric patients, including those with CML. 30 An initial dose at 260-570 mg/m 2 /day was safely administered to patients aged 3-20 years (median age, 14 years).…”

Section: Imatinibmentioning

confidence: 99%

“…The number of publications regarding imatinib in childhood CML is limited . The Children's Oncology Group performed a phase I study of imatinib in 31 pediatric patients, including those with CML .…”

Section: Tki In Pediatric CMLmentioning

confidence: 99%

Optimal management for pediatric chronic myeloid leukemia

Tanizawa

2016

Pediatrics International

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Chronic myeloid leukemia (CML) is rare among childhood leukemias. Its incidence increases with age, from 0.09/100 000 at ≤15 years old to 7.88/100 000 at ≥75 years old. There are several biological and clinical differences between pediatric and adult CML. Markedly increased leukocyte count and a higher incidence of splenomegaly are characteristic features at diagnosis in pediatric patients. The therapeutic approach to CML has changed since the introduction of the tyrosine kinase inhibitor (TKI) imatinib, followed by dasatinib and nilotinib. Given the efficacy of TKI in adult CML, TKI are regarded as the established first-line treatment in adult patients. In 2011, a prospective phase IV study in pediatric patients showed the excellent efficacy and safety of imatinib. Imatinib is also accepted as a first-line option for childhood chronic phase CML. Although the efficacy of dasatinib and nilotinib reported in adult studies seems very attractive for pediatric patients, neither drug has been prospectively investigated in a large pediatric cohort. TKI are designed to inhibit BCR-ABL1 kinase, but they have unfavorable effects, so-called "off-target" complications, such as growth impairment. Long-term morbidity due to TKI is unknown. Furthermore, the adverse effects on growing children have not been clearly elucidated, even though the exposure period to imatinib is relatively short. To establish the standard therapeutic management for pediatric CML, it is important to prospectively confirm the attractive outcomes obtained in adult studies via pediatric clinical trials with a careful monitoring system for TKI-induced adverse effects, especially in growing children.

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Clinical characteristics and treatment outcome of pediatric patients with chronic myeloid leukemia

Cited by 15 publications

References 17 publications

Paediatric Chronic Myeloid Leukaemia in a Tertiary Hospital in Nigeria: A Report of Two Cases

Paediatric Chronic Myeloid Leukaemia in a Tertiary Hospital in Nigeria: A Report of Two Cases

Clinical characteristics and treatment outcome of pediatric patients with chronic myeloid leukemia

Optimal management for pediatric chronic myeloid leukemia

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