Cancers (Mar 2024)
Treatment Outcomes of Adolescents Compared to Younger Pediatric Patients with Acute Myeloid Leukemia: Do They Need a Special Approach?
- Katarzyna Pawińska-Wąsikowska,
- Małgorzata Czogała,
- Karolina Bukowska-Strakova,
- Marta Surman,
- Monika Rygielska,
- Teofila Książek,
- Beata Sadowska,
- Agnieszka Pac,
- Jolanta Skalska-Sadowska,
- Magdalena Samborska,
- Jacek Wachowiak,
- Małgorzata Ciebiera,
- Radosław Chaber,
- Renata Tomaszewska,
- Tomasz Szczepański,
- Karolina Zielezińska,
- Tomasz Urasiński,
- Małgorzata Moj-Hackemer,
- Krzysztof Kałwak,
- Marta Kozłowska,
- Ninela Irga-Jaworska,
- Barbara Sikorska-Fic,
- Paweł Łaguna,
- Katarzyna Muszyńska-Rosłan,
- Maryna Krawczuk-Rybak,
- Anna Fałkowska,
- Katarzyna Drabko,
- Katarzyna Bobeff,
- Wojciech Młynarski,
- Agnieszka Chodała-Grzywacz,
- Grażyna Karolczyk,
- Katarzyna Mycko,
- Wanda Badowska,
- Natalia Bartoszewicz,
- Jan Styczyński,
- Katarzyna Machnik,
- Agnieszka Mizia-Malarz,
- Walentyna Balwierz,
- Szymon Skoczeń
Affiliations
- Katarzyna Pawińska-Wąsikowska
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
- Małgorzata Czogała
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
- Karolina Bukowska-Strakova
- Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
- Marta Surman
- Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
- Monika Rygielska
- Department of Pediatric Oncology and Hematology, Hematology Laboratory, University Children’s Hospital, 30-663 Krakow, Poland
- Teofila Książek
- Department of Medical Genetics, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
- Beata Sadowska
- Department of Pediatric Oncology and Hematology, Cytogenetics and Molecular Genetics Laboratory, University Children’s Hospital, 30-663 Krakow, Poland
- Agnieszka Pac
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Jagiellonian University Medical College, 31-034 Krakow, Poland
- Jolanta Skalska-Sadowska
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60-572 Poznan, Poland
- Magdalena Samborska
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60-572 Poznan, Poland
- Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60-572 Poznan, Poland
- Małgorzata Ciebiera
- Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, 35-301 Rzeszow, Poland
- Radosław Chaber
- Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, 35-301 Rzeszow, Poland
- Renata Tomaszewska
- Department of Pediatric Hematology and Oncology, Medical University of Silesia, 40-055 Katowice, Poland
- Tomasz Szczepański
- Department of Pediatric Hematology and Oncology, Medical University of Silesia, 40-055 Katowice, Poland
- Karolina Zielezińska
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
- Tomasz Urasiński
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
- Małgorzata Moj-Hackemer
- Clinical Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland
- Krzysztof Kałwak
- Clinical Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland
- Marta Kozłowska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 80-210 Gdansk, Poland
- Ninela Irga-Jaworska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, 80-210 Gdansk, Poland
- Barbara Sikorska-Fic
- Department of Oncology, Pediatric Hematology, Transplantology and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
- Paweł Łaguna
- Department of Oncology, Pediatric Hematology, Transplantology and Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
- Katarzyna Muszyńska-Rosłan
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-276 Bialystok, Poland
- Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, 15-276 Bialystok, Poland
- Anna Fałkowska
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-090 Lublin, Poland
- Katarzyna Drabko
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-090 Lublin, Poland
- Katarzyna Bobeff
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, 91-738 Lodz, Poland
- Wojciech Młynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, 91-738 Lodz, Poland
- Agnieszka Chodała-Grzywacz
- Department of Pediatric Hematology and Oncology, Regional Polyclinic Hospital in Kielce, 25-736 Kielce, Poland
- Grażyna Karolczyk
- Department of Pediatric Hematology and Oncology, Regional Polyclinic Hospital in Kielce, 25-736 Kielce, Poland
- Katarzyna Mycko
- Department of Pediatrics and Hematology and Oncology, Province Children’s Hospital, 10-561 Olsztyn, Poland
- Wanda Badowska
- Department of Pediatrics and Hematology and Oncology, Province Children’s Hospital, 10-561 Olsztyn, Poland
- Natalia Bartoszewicz
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, 85-094 Bydgoszcz, Poland
- Jan Styczyński
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, 85-094 Bydgoszcz, Poland
- Katarzyna Machnik
- Department of Pediatrics, Hematology and Oncology, City Hospital, 41-500 Chorzow, Poland
- Agnieszka Mizia-Malarz
- Department of Pediatrics, Medical University of Silesia, Upper Silesia Children’s Care Health Centre, 40-752 Katowice, Poland
- Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
- Szymon Skoczeń
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland
- DOI
- https://doi.org/10.3390/cancers16061145
- Journal volume & issue
-
Vol. 16,
no. 6
p. 1145
Abstract
Background: The reports of studies that compare the survival of adolescents and young adults with younger children with acute myeloid leukemia (AML) are contradictory. Patients and Methods: We retrospectively analyzed 220 AML patients aged 0–18 years treated in pediatric oncologic centers in Poland from 2015 to 2022. The evaluated group included 31 infants (below 1 year), 91 younger children (1–9.9 years), 59 older children (10–14.9 years), and 39 adolescents (15–18 years). Results: A 5-year overall survival for adolescents was not significantly inferior compared to younger and older children (74.3 ± 7.6% vs. 80.5 ± 4.4% vs. 77.9 ± 5.1, p = 0.243). However, relapse-free survival was lower in adolescents compared to younger children (76.5 ± 7.8% vs. 65.7 ± 9.0%, p = 0.049), and treatment-related mortality tended to be higher (10.3% vs. 4.4%, p = 0.569). In the univariate analysis, high-risk genetics [HR, 2.0 (95% CI 1.1–3.6; p = 0.014)] and a leukocyte count at diagnosis above 100,000/μL [HR, 2.4 (95% CI 1.3–4.6; p = 0.004)] were found to be unfavorable prognostic factors for survival. Conclusions: Although we have not found that age over 15 years is an unfavorable factor for overall survival, the optimal approach to therapy in adolescents, as in other age groups, is to adjust the intensity of therapy to individual genetic risk and introduce targeted therapies when indicated.
Keywords