Outcome of pediatric patients with acute myeloid leukemia (AML) and -5/5q- abnormalities from five pediatric AML treatment protocols: A report from the Children's Oncology Group

Donna L. Johnston, Todd A. Alonzo, Robert B. Gerbing, Betsy Hirsch, Nyla A. Heerema, Yaddanapudi Ravindranath, William G. Woods, Beverly J. Lange, Alan S. Gamis, Susana C. Raimondi

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10 Scopus citations

Abstract

Background: Abnormalities of chromosome 5q (-5/5q-) are associated with poor prognosis in adults with acute myeloid leukemia (AML). However, there are no large studies on outcomes of children with -5/5q- AML. To determine the disease correlates of this group, we retrospectively analyzed cytogenetic data from five studies of childhood AML. Procedure: Data from patients whose cytogenetic clones included -5/5q-, with the exception of those with acute promyelocytic leukemia or Down syndrome, were included. Results: Of the 2,240 patients with cytogenetic data available, 26 (1.2%) had -5 or 5q-. A significant number of these patients were age 11-21 (61.5%, P=0.031) and had M0 morphology compared with patients without -5/5q- (24.0% vs. 2.8%, P<0.001). Twenty-two of the 26 patients had a complete remission (CR) response to induction chemotherapy. The 5-year overall survival (OS) from the time of diagnosis for the -5/5q- patients was significantly lower than for patients without -5/5q- (27±17% vs. 50±2%, P=0.027). Similarly, from induction CR, patients with -5/5q- had significantly worse disease free survival, OS and relapse risk than those without this abnormality (27±19% vs. 46±2%, P=0.035, 32±20% vs. 57±2%, P=0.025, 68±21% vs. 45±2%, P=0.01, respectively). Conclusions: Pediatric patients with AML and -5/5q- had a very poor outcome. These findings support the need for new or novel therapies for these patients. Pediatr Blood Cancer 2013;60:2073-2078.

Original languageEnglish (US)
Pages (from-to)2073-2078
Number of pages6
JournalPediatric Blood and Cancer
Volume60
Issue number12
DOIs
StatePublished - Dec 2013

Keywords

  • -5/5q- abnormalities
  • Acute myeloid leukemia
  • Chromosome 5
  • Outcome
  • Pediatric AML

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