Excellent Survival Outcomes Of Pediatric Patients With Acute Myeloid Leukemia Treated With The Maspore 2006 Protocol

This study was to determine the prognostic factors of pediatric acute myeloid leukemia and to assess whether the outcomes have improved over time. Sixty-two patients were treated either using the earlier Medical Research Council AML12 protocol or the more recent MASPORE 2006 protocol. The more recent protocol was associated with an excellent 10-year overall survival rate of 88% and an event-free survival rate of 72%.Purpose: To determine the prognostic factors in pediatric patients with acute myeloid leukemia (AML) and to assess whether their outcomes have improved over time. Patients and Methods: Sixty-two patients with AML excluding acute promyelocytic leukemia were retrospectively analyzed. Patients in the earlier cohort (n = 36) were treated on the Medical Research Council (MRC) AML12 protocol, whereas those in the recent cohort (n = 26) were treated on the Malaysia -Singapore AML protocol (MASPORE 2006), which differed in terms of risk group stratification, cumulative anthracycline dose, and timing of hematopoietic stem-cell transplantation for high-risk patients. Results: Significant improvements in 10-year overall survival and event-free survival were observed in patients treated with the recent MASPORE 2006 protocol compared to the earlier MRC AML12 protocol (overall survival: 88.0% +/- 6.5% vs 50.1% +/- 8.6%, P = .002; event-free survival: 72.1% +/- 9.0 vs 50.1% +/- 8.6%, P = .045). In univariate analysis, patients in the recent cohort had significantly lower intensive care unit admission rate (11.5% vs 47.2%, P = .005) and numerically lower relapse rate (26.9% vs 50.0%, P = .068) compared to the earlier cohort. Multivariate analysis showed that treatment protocol was the only independent predictive factor for overall survival (hazard ratio = 0.21; 95% confidence interval, 0.06-0.73, P = .014). Conclusion: Outcomes of pediatric AML patients have improved over time. The more recent MASPORE 2006 protocol led to significant improvement in long-term survival rates and reduction in intensive care unit admission rate. (C) 2020 Elsevier Inc. All rights reserved.