Identifying Prognostic Factors That Influence Outcome of Childhood Acute Myeloid Leukemia in First Relapse in Saudi Arabia: Results of the Multicenter SAPHOS Study

Jastaniah, Wasil; Bayoumy, Mohamed; Alsultan, Abdulrahman; Daama, Saad Al; Ballourah, Walid; Al-Anzi, Faisal; Shareef, Omar Al; Sudairy, Reem Al; Abrar, Mohammed Burhan; Ghemlas, Ibrahim

doi:10.1016/j.clml.2018.09.001

Cited by 5 publications

(9 citation statements)

References 17 publications

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“…Complete remission rate in Vietnam was 82.6%, 11 Pakistan was 80%, 12 and Saudi Arabia was 86%. 5 Nevertheless, the remission rate in this study was higher than the data of pediatric AML in RSCM in year 2010 which was 32%. 13 This improvement of remission rate may be caused by protocol changes after year 2011, when the National AML protocol was started to use.…”

Section: Discussioncontrasting

confidence: 68%

“…A previous study shows that 3-year OS of all AML patients was 22.6±5.4%, while prognosis of cytogenetic abnormality of subjects with (inv)16 was 75.0±21.7% and subject with t(8;21) was 36.0±16.1%. 5 Our study was the first study in Indonesia to examine the karyotype in children with AML. The data obtained from this study could be very useful for further management to treat AML in children in Indonesia.…”

Section: Discussionmentioning

confidence: 96%

“…Translocation of t(8;21) were found variably. Incidence of t(8;21) in pediatric AML patients were 15% in Saudi Arabia, 4,5 15% in China, 6 24% in Japan, 7 26-29% in India. 8,9 A study stated that t(8;21) expression in Asian children tends to be higher compared to Europe and North America.…”

Section: Discussionmentioning

confidence: 98%

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Role of cytogenetic profiles as prognostic factors for complete remission after induction phase in acute myeloblastic leukemia

Sjakti¹,

Gatot²,

Wahidiyat³

et al. 2021

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Background Risk stratification for acute myeloid leukemia (AML) in children is a must in treatment strategy. This stratification is based on cytogenetic profiles, which are needed to determine proper management to gain better outcomes and reduce side effects of treatment. There is no such risk stratification available in Indonesia until now. Objective To evaluate the association between cytogenetic profiles of t(8,21) and inv(16) mutations with the complete response to induction phase of chemotherapy in pediatric AML. Methods A prospective study was conducted between year 2018 and 2020, involving children with AML from 4 pediatric oncology centers in Jakarta. Subjects were evaluated for cytogenetic profiles, especially t(8,21) and inv(16), as the favorable predictors for AML. Bone marrow remission was evaluated after 2 cycles of induction phase. The results were evaluated for remission rate and survival analysis. Results Karyotype data of 18 subjects were obtained. Translocation t(8;21) detected in 1 subject, and inv(16) mutation in 4 subjects. These two variables had no significant correlation with complete remission after induction phase. Nevertheless, favorable group had more tendencies to achieved remission than unfavorable group. Complete remission achieved in 61% subjects, 90% of theme had a relapse period with an average time 43 weeks. The relapse period in favorable group was shoter than in unfavorable group (34 weeks and 44 weeks, respectively). Conclusions This study shows that cytogenetic profiles of t(8;21) and inv(16) mutation can not be used as prognostic factors for complete remission after induction phase of chemotherapy in pediatric AML.

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 96%

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Role of cytogenetic profiles as prognostic factors for complete remission after induction phase in acute myeloblastic leukemia

Sjakti¹,

Gatot²,

Wahidiyat³

et al. 2021

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“…The all-cause survival after relapse depended mainly on age and cytogenetics at diagnosis. Analysis of prognosis factors that influence the post-relapse survival outcome of childhood patients with AML found sex as a predictor, but it was not significant, with a higher risk of mortality observed in men compared to women (HR = 1.30, not significant) [35]. Sex differences in survival after relapsed AML (better for women) could be related to the slight sex differences seen in the time to cure, with a slightly reduced delay in women compared to men in several AML subtypes.…”

Section: Discussionmentioning

confidence: 85%

Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM

Mounier

Romain

Callanan

et al. 2021

JCM

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With improvements in acute myeloid leukemia (AML) diagnosis and treatment, more patients are surviving for longer periods. A French population of 9453 AML patients aged ≥15 years diagnosed from 1995 to 2015 was studied to quantify the proportion cured (P), time to cure (TTC) and median survival of patients who are not cured (MedS). Net survival (NS) was estimated using a flexible model adjusted for age and sex in sixteen AML subtypes. When cure assumption was acceptable, the flexible cure model was used to estimate P, TTC and MedS for the uncured patients. The 5-year NS varied from 68% to 9% in men and from 77% to 11% in women in acute promyelocytic leukemia (AML-APL) and in therapy-related AML (t-AML), respectively. Major age-differenced survival was observed for patients with a diagnosis of AML with recurrent cytogenetic abnormalities. A poorer survival in younger patients was found in t-AML and AML with minimal differentiation. An atypical survival profile was found for acute myelomonocytic leukemia and AML without maturation in both sexes and for AML not otherwise specified (only for men) according to age, with a better prognosis for middle-aged compared to younger patients. Sex disparity regarding survival was observed in younger patients with t-AML diagnosed at 25 years of age (+28% at 5 years in men compared to women) and in AML with minimal differentiation (+23% at 5 years in women compared to men). All AML subtypes included an age group for which the assumption of cure was acceptable, although P varied from 90% in younger women with AML-APL to 3% in older men with acute monoblastic and monocytic leukemia. Increased P was associated with shorter TTC. A sizeable proportion of AML patients do not achieve cure, and MedS for these did not exceed 23 months. We identify AML subsets where cure assumption is negative, thus pointing to priority areas for future research efforts.

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“…In the following survival analysis, we excluded 21 patients who gave up treatment after diagnosis. Three patients with negative FISH and PCR results died early, with karyotypes 47, XX, +21 [4]/48, idem, +8 [16]; 46, XX [20]; and no split phase. Of the 73 patients receiving treatment, the CR rate of treatment was 70% in the first course, rising to 94% in the second course.…”

Section: Analysis Of Curative Rate and Prognostic Factorsmentioning

confidence: 99%

Cytogenetic characteristics of and prognosis for acute myeloid leukemia in 107 children

2021

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Background Patients diagnosed with acute myeloid leukemia (AML) in childhood have a poor prognosis. A better understanding of prognostic factors will assist patients and clinicians in making difficult treatment decisions. Objectives To understand further the cytogenetic characteristics of and reassess the prognostic value of cytogenetic abnormalities in childhood AML. Methods Conventional karyotypes of 107 children with AML were analyzed retrospectively. The cases were divided into 4 groups based on genetic rearrangements; namely patients with: t(15;17)/PML-RARA; t(8;21)/RUNX1-RUNX1T1 or inv(16)(p13;q22) and t(16;16)/CBFB-MYH11; −7 or complex karyotypes; normal karyotypes or other cytogenetic changes. Differences in age, sex, leukocyte count, event-free survival (EFS), and overall survival (OS) were analyzed. Results All French-American-British (FAB) subtypes of AML were detected in 107 patients. We successfully cultured 81 of 107 bone marrow specimens, of which 60 cases had abnormal karyotypes. The most common abnormal karyotypes were t(8;21) (17/81 cases), followed by t(15;17) (13/81 cases), –X/Y (10/81 cases). There were no significant differences (P > 0.05) in age, sex, or leukocyte counts between the 4 groups. The differences in 3-year EFS and OS between each pair were significant, except for groups of patients with t(8;21)/RUNX1-RUNX1T1 and patients with normal karyotypes or other cytogenetic changes (P = 0.054). Conclusions Chromosomal abnormalities may provide important prognostic factors for AML in children and be helpful for risk stratification and individual treatment.

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Identifying Prognostic Factors That Influence Outcome of Childhood Acute Myeloid Leukemia in First Relapse in Saudi Arabia: Results of the Multicenter SAPHOS Study

Cited by 5 publications

References 17 publications

Role of cytogenetic profiles as prognostic factors for complete remission after induction phase in acute myeloblastic leukemia

Role of cytogenetic profiles as prognostic factors for complete remission after induction phase in acute myeloblastic leukemia

Flexible Modeling of Net Survival and Cure by AML Subtype and Age: A French Population-Based Study from FRANCIM

Cytogenetic characteristics of and prognosis for acute myeloid leukemia in 107 children

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