Treatment of Acute Myeloid Leukemia in Children: Experience from a Tertiary Care Hematology Centre in India

Gupta, Nitin; Seth, Tulika; Mishra, Pravas; Mahapatra, Manoranjan; Rathi, Satyajeet S.; Kapoor, Rajan; Agarwal, Narendra; Kumar, Suman; Saxena, Renu

doi:10.1007/s12098-010-0300-1

Cited by 8 publications

(25 citation statements)

References 13 publications

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“…TRM has been very high in our center, which indicates that we need to improve our supportive care. A very low TRM of 5.7% has been reported from another center in India in 35 patients of pediatric AML treated with less intensive protocol, but 48.5% relapsed [8].…”

Section: Pediatric Acute Myeloid Leukemia (Aml) Is the Final Frontiermentioning

confidence: 82%

Pediatric Acute Myeloid Leukemia: Final Frontier for Pediatric Oncologists in Developing World

Yadav

Ramzan

Lall

et al. 2011

Pediatric Hematology and Oncology

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  S. P. Yadav et al. complex cytogenetics in 2, XO in 2, trisomy 8 in 1) disease. In the favorable-risk group, 4 died, 5 were lost to follow-up, and only 1 is alive. Among 5 patients with t(15; 17), only 2 opted for therapy. One died in induction with intracranial bleed and the other relapsed 1 year after finishing therapy. In the intermediate-risk group, 2 died during induction and 2 are alive and disease-free. In the high-risk group, 3 died, 2 were lost to follow-up, and 2 are alive with 1 disease-free.High mortality with intensive protocol, high relapse rates with less intensive protocols, and treatment abandonment are major barriers to improving outcome for pediatric AML in the developing world. Less intensive protocols with better efficacy are the need of the hour. Declaration of interestPediatric Hematology and Oncology

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Section: Pediatric Acute Myeloid Leukemia (Aml) Is the Final Frontiermentioning

confidence: 82%

Pediatric Acute Myeloid Leukemia: Final Frontier for Pediatric Oncologists in Developing World

Yadav

Ramzan

Lall

et al. 2011

Pediatric Hematology and Oncology

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“…ED rates varied from 3% to 59% (n=18 studies). ED rates were high overall, as only two studies reported ED rates below 5% [22,39]. In two studies [40,42], a drop in ED rate below 10% was achieved by optimization of supportive care measures.…”

Section: Treatment Outcomes Of Pediatric Aml In Lmicsmentioning

confidence: 94%

“…CR rates varied from 32% to 100% (n=19 studies), and nine studies described a CR rate of 80% or higher [22,27,28,30,36,39,40,42,45]. CR rates were over 64% in the remaining ten studies, with the exception of two which described CR rates of merely 35% [29,38].…”

Section: Treatment Outcomes Of Pediatric Aml In Lmicsmentioning

confidence: 99%

“…In all but one of the studies [34], induction courses were based on a two-or three-drug regimen: cytarabine and an anthracycline (i.e., daunorubicin, doxorubicin, idarubicin), or a combination of these two drugs with etoposide. As the second induction course, a few studies administered highdose cytarabine in combination with mitoxantrone [22,28,31,40]. For consolidation courses, the most commonly used chemotherapeutic agent was cytarabine, either administered alone or in combination with an anthracycline or etoposide.…”

Section: Treatment Protocols and Chemotherapeutic Agentsmentioning

confidence: 99%

“…The high ED and TRM rates were mainly attributed to a lack of adequate supportive care, which was reflected in the reported reasons for these deathsnamely sepsis or other severe infections and hemorrhages. It is worth noting that some studies with relatively low ED and/or TRM rates applied a two-drug induction regimen during the first part of their study period [26,35,39] or as the first induction course [22,26,35,39], and that in two of these studies relapse rates were very high (>50%) [22,26]. Furthermore, the study with a TRM rate of 0% included a selected group of patients (n=40) who all achieved CR and underwent auto-SCT [27].…”

Section: Treatment Outcomes Of Pediatric Aml In Lmicsmentioning

confidence: 99%

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Outcome of pediatric acute myeloid leukemia (AML) in low- and middle-income countries: a systematic review of the literature

Weelderen

Klein

Natawidjaja

et al. 2021

Expert Review of Anticancer Therapy

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Introduction: Survival rates of pediatric acute myeloid leukemia (AML) in low-and middle-income countries (LMICs) seem extremely poor, and the available literature on the matter is scarce. Accordingly, there is a limited understanding of poor treatment outcomes seen in this population. Areas covered: We provide an overview of the available literature with respect to treatment outcomes of pediatric AML in LMICs yielding poor outcomes compared to high-income countries. Moreover, treatment outcomes vary markedly between LMICs. In addition, there is a wide variation among studies in how treatment outcomes are reported and analyzed. Expert opinion: The substantially inferior treatment outcomes of pediatric AML in LMICs emphasize the unprecedented importance of global initiatives and international collaborations to improve the survival of these patients. A coordinated approach is necessary to carry out country-specific situational analyses. These analyses will result in operational plans on how to structurally implement childhood cancer registries, align healthcare infrastructure, build on capacities, and provide universal health coverage in LMICs. In addition, we strongly recommend that, in the future, LMICs document, analyze, and publish pediatric AML treatment outcomes in a more structured and uniform manner.

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Surveillance Stool Culture and its Association with Microbiologically Documented Infection During Febrile Neutropenia in Patients with Acute Leukemia (AL) Undergoing Induction Chemotherapy

Jadhav

Mandal

Kayal

et al. 2020

Indian J Hematol Blood Transfus

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The study aimed at identifying the profile of gut colonization of patients with acute leukemia who underwent induction chemotherapy and its association with induction events and outcome. Baseline bacterial stool culture with resistance pattern of isolates were recorded. Multi-drug resistance was defined as resistance to at least two antibiotic classes including beta lactam and fluoroquinolones. During induction chemotherapy, blood and clinically indicated cultures were taken during febrile neutropenic episodes. Association studies were done between gut colonization and induction events/outcome. Among 109 patients enrolled, 71 (65.13%) patients undergoing induction chemotherapy were colonized with bacteria, with nearly 50% of colonizers harboring multidrug resistant bacteria. Organisms isolated from stool preinduction were mostly gram negative (98%), with Escherichia coli and Klebsiella pneumoniae being the commonest. 65.13% patients developed febrile neutropenia. Overall multi-drug resistant positivity during febrile neutropenia was 70.14%. Concordance of 8.45% was observed between isolates from stool and organisms isolated from cultures during febrile neutropenia. There were significant proportion of gut colonized gram-negative multi-drug resistance bacteria among patients with acute leukemia. There was a low concordance rate between baseline stool isolates and subsequent cultures during the induction. There was no significant association between gut colonization and induction events/outcomes studied.

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Treatment of Acute Myeloid Leukemia in Children: Experience from a Tertiary Care Hematology Centre in India

Cited by 8 publications

References 13 publications

Pediatric Acute Myeloid Leukemia: Final Frontier for Pediatric Oncologists in Developing World

Pediatric Acute Myeloid Leukemia: Final Frontier for Pediatric Oncologists in Developing World

Outcome of pediatric acute myeloid leukemia (AML) in low- and middle-income countries: a systematic review of the literature

Surveillance Stool Culture and its Association with Microbiologically Documented Infection During Febrile Neutropenia in Patients with Acute Leukemia (AL) Undergoing Induction Chemotherapy

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