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19 - Acute myeloid leukemia

from Part III - Evaluation and treatment

Published online by Cambridge University Press:  01 July 2010

By
Jeffrey E. Rubnitz ,
Bassem I. Razzouk  and
Raul C. Ribeiro
Edited by
Ching-Hon Pui
Jeffrey E. Rubnitz
Affiliation:
Associate Member, Department of Hematology/Oncology, Director of Fellowship Program, St. Jude Children's Research Hospital, Memphis, TN, USA
Bassem I. Razzouk
Affiliation:
Associate Member, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
Raul C. Ribeiro
Affiliation:
Member, Department of Hematology/Oncology, Director, International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN, USA
Ching-Hon Pui
Affiliation:
St. Jude Children's Research Hospital, Memphis
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Summary

Introduction

Acute myeloid leukemia (AML) is a heterogeneous group of hematopoietic malignancies characterized by the proliferation of abnormal leukemic blast cells and impaired production of normal blood cells. AML accounts for only 15% to 20% of cases of acute leukemia in children and adolescents, but is responsible for more than one third of the deaths due to leukemia in these age groups.

The outcome of treatment for children with AML has improved markedly over the last three decades: about half of all affected children now remain free of disease at 5 years from diagnosis and are probably cured. This improvement has been accomplished by enrolling pediatric patients in clinical trials, administering more intensive therapy (including hematopoietic stem cell transplantation), and improving supportive care. However, the cure rate for children with AML continues to lag behind that for children with acute lymphoblastic leukemia (ALL). The main reasons for treatment failure are relapse and treatment-related mortality. A major challenge is the development of novel therapies that overcome drug resistance and decrease relapse rates, while reducing the short- and long-term adverse effects of treatment. Recent advances in understanding the molecular heterogeneity of AML and in identifying specific molecular therapeutic targets should provide essential information needed to meet this challenge. Here we update findings on the epidemiology and pathogenesis of AML in children and adolescents and discuss treatment options, supportive care issues, and complications of therapy.

Epidemiology and risk factors

AML accounts for approximately 16% of the acute leukemias in children and adolescents younger than 15 years.

Information

Type
Chapter
Information
Childhood Leukemias , pp. 499 - 539
Publisher: Cambridge University Press
Print publication year: 2006

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  • Acute myeloid leukemia
    • By Jeffrey E. Rubnitz, Associate Member, Department of Hematology/Oncology, Director of Fellowship Program, St. Jude Children's Research Hospital, Memphis, TN, USA, Bassem I. Razzouk, Associate Member, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA, Raul C. Ribeiro, Member, Department of Hematology/Oncology, Director, International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.020
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  • Acute myeloid leukemia
    • By Jeffrey E. Rubnitz, Associate Member, Department of Hematology/Oncology, Director of Fellowship Program, St. Jude Children's Research Hospital, Memphis, TN, USA, Bassem I. Razzouk, Associate Member, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA, Raul C. Ribeiro, Member, Department of Hematology/Oncology, Director, International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.020
Available formats
×

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  • Acute myeloid leukemia
    • By Jeffrey E. Rubnitz, Associate Member, Department of Hematology/Oncology, Director of Fellowship Program, St. Jude Children's Research Hospital, Memphis, TN, USA, Bassem I. Razzouk, Associate Member, Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA, Raul C. Ribeiro, Member, Department of Hematology/Oncology, Director, International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.020
Available formats
×