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Text
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<a href="http://doi.org/10.1002/pbc.24942" target="_blank" rel="noreferrer">http://doi.org/10.1002/pbc.24942</a>
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Title
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Outcome of children treated for relapsed acute myeloid leukemia in Central America
Publisher
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Pediatric Blood & Cancer
Date
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2014
Subject
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adolescent; Child; Female; Humans; Male; retrospective studies; Survival Rate; Time Factors; Leukemia; Preschool; Acute; Central America; Disease-Free Survival; Promyelocytic; Recurrence
Creator
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Marjerrison S; Antillon F; Bonilla M; Fu L; Martinez R; Valverde P; Vasquez R; Howard SC; Ribeiro RC; Sung L
Description
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BACKGROUND: Relapsed childhood acute myeloid leukemia (AML) outcomes have not been documented in resource-limited settings. We examined survival after relapse for children with AML (non-APML) and acute promyelocytic leukemia (APML) in Central America. PROCEDURE: We retrospectively evaluated outcomes of children with first relapse of AML (non-APML) and APML in Guatemala, Honduras, or El Salvador diagnosed between 1997 and 2011. Predictors of subsequent event-free survival (EFS) and overall survival (OS) were examined. RESULTS: We identified 140 children with relapsed AML (non-APML), and 24 with relapsed APML. Two-year subsequent EFS and OS (±SE) were 7.0 ± 2.5% and 9.1 ± 2.8%, respectively. Worse outcomes were associated with Hispanic or Indigenous heritage, white blood cell count at diagnosis ≥50 × 10(9) /L, and time to relapse <18 months. For those with relapsed APML, subsequent 2-year EFS and OS were 36.7 ± 10.8% and 43.4 ± 12.1%, although few patients survived beyond 3 years. 15.2% of all patients were managed solely with palliative intent following first relapse. CONCLUSIONS: Children with relapsed AML in Central America rarely survive, so palliative strategies should be considered following relapse in this population. However, children with late relapse or with APML may have a prolonged period of remission with second treatment, and consideration of re-treatment may be appropriate.
2014-07
Identifier
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<a href="http://doi.org/10.1002/pbc.24942" target="_blank" rel="noreferrer">10.1002/pbc.24942</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2014
Acute
Adolescent
Antillon F
Backlog
Bonilla M
Central America
Child
Disease-Free Survival
Female
Fu L
Howard SC
Humans
Journal Article
Leukemia
Male
Marjerrison S
Martinez R
Pediatric Blood & Cancer
Preschool
Promyelocytic
Recurrence
Retrospective Studies
Ribeiro RC
Sung L
Survival Rate
Time Factors
Valverde P
Vasquez R