Document Detail


Superior outcome of pediatric acute myeloid leukemia patients with orbital and CNS myeloid sarcoma: a report from the Children's Oncology Group.
MedLine Citation:
PMID:  21618422     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Extramedullary leukemia (EML) is common in pediatric acute myeloid leukemia (AML) and occurs as leukemia cells within the cerebrospinal fluid (CSF) or as a solid tumor (myeloid sarcoma-MS). The effect of MS on survival is unknown.
METHODS: Patients on CCG protocols 2861, 2891, 2941, and 2961 being treated for AML with intensive-timing chemotherapy were classified for the presence of EML (CSF leukemia, CNS-MS, orbital-MS, or non-CNS MS). CSF leukemia was classified as CNS3 (>5 WBC in the CSF with blasts) and non-CSF leukemia as CNS1/2 (<5 WBC in the CSF with or without blasts). Characteristics and outcomes of these patients were compared.
RESULTS: Of the 1,459 total patients, 1,206 (82%) had no EML, 154 (11%) had CSF leukemia, 19 (1%) had CNS-MS, 23 (2%) had orbital-MS, and 57 (4%) had non-CNS MS. The CR rate was significantly higher in patients with orbital-MS and CNS-MS than in those with non-MS and non-CNS MS (96% and 95% vs. 78% and 78%, P = 0.034). Patients with orbital-MS and CNS-MS had significantly higher overall survival than patients with non-CNS MS (92% and 73% vs. 38%, P < 0.001), CNS3 patients (92% and 73% vs. 51, P < 0.001), and CNS1/2 patients (92% and 73% vs. 50%, P < 0.001). Patients with orbital-MS had a significantly lower relapse rate.
CONCLUSION: Patients with MS involving orbital and CNS sites had a significantly better survival than patients with non-CNS MS, with CSF leukemia, or with no EML.
Authors:
Donna L Johnston; Todd A Alonzo; Robert B Gerbing; Beverly J Lange; William G Woods
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2011-05-25
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  58     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-02-14     Completed Date:  2012-04-06     Revised Date:  2014-09-15    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  519-24     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*,  adverse effects
Central Nervous System Neoplasms* / classification,  drug therapy,  mortality
Child
Child, Preschool
Disease-Free Survival
Female
Humans
Infant
Infant, Newborn
Leukemia, Myeloid, Acute* / classification,  drug therapy,  mortality
Male
Middle Aged
Neoplasms, Second Primary* / classification,  drug therapy,  mortality
Orbital Neoplasms* / classification,  drug therapy,  mortality
Sarcoma, Myeloid* / classification,  drug therapy,  mortality
Survival Rate
Grant Support
ID/Acronym/Agency:
U10 CA098413-04/CA/NCI NIH HHS; U10 CA098543/CA/NCI NIH HHS; U10 CA098543-01/CA/NCI NIH HHS; U10 CA98413/CA/NCI NIH HHS; U10 CA98543/CA/NCI NIH HHS
Comments/Corrections

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