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The Oncologist, Vol. 12, No. 3, 341-355, March 2007; doi:10.1634/theoncologist.12-3-341
© 2007 AlphaMed Press

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Pediatric Oncology

Prognostic Factors and Risk-Based Therapy in Pediatric Acute Myeloid Leukemia

Soheil Meshinchia, Robert J. Arcecib

aFred Hutchinson Cancer Research Center, University of Washington, Department of Pediatrics, Division of Clinical Research, Seattle, Washington, USA; bPediatric Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA

Correspondence: Robert J. Arceci, M.D., Ph.D., Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Bunting-Blaustein Cancer Research Building, 1650 Orleans Street, Room 2M51, Baltimore, Maryland 21231, USA. Telephone: 410-502-7519; Fax: 410-502-7223; email: arcecro{at}jhmi.edu

Acute myeloid leukemia (AML) has posed significant therapeutic challenges to pediatric oncologists. Despite intensive therapy, half of the children with AML relapse and die from their disease. Efforts to identify risk factors in AML are directed toward defining populations who may benefit from alternative therapies. Patients at lower risk for relapse may benefit from treatment de-escalation, sparing them adverse side effects. Management of high-risk patients may prove more difficult, as the nearly myeloablative nature of AML therapy leaves little room for therapy escalation short of stem cell transplantation. This review evaluates prognostic factors in pediatric AML and discusses the feasibility of using these factors in risk-adapted therapy regimens.

Disclosure of potential conflicts of interest is found at the end of this article.




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