Long-term survival outcome of childhood acute myeloid leukemia: a 43-year experience in Thailand, a resource-limited country

Leuk Lymphoma. 2024 Dec;65(12):1830-1839. doi: 10.1080/10428194.2024.2382916. Epub 2024 Jul 26.

Abstract

Although there have been advances in treating pediatric patients with acute myeloid leukemia (AML) in developed countries, outcomes in low- to middle-income countries remain poor. The goal of this study was to investigate the outcomes in children with AML who were treated at a tertiary care center in Thailand. We divided the study into 4 research periods based on the chemotherapy protocols employed. The 5-year probabilities of event-free survival (pEFS) rates for periods 1-4 were 19.0%, 20.6%, 17.4%, and 37.3% (p value = 0.32), while the 5-year probabilities of overall survival (pOS) rates were 19.0%, 24.7%, 18.7%, and 42.5% (p value = 0.18), respectively. The multivariable model indicated an improvement in 5-year pOS between periods 1 and 4 (p value = 0.04). Age, white blood cell count, and study period were significant predictors of survival outcomes. The pOS of AML patients improved over time, increasing from 19.0% to 42.5%.

Keywords: Acute myeloid leukemia; childhood leukemia; long-term treatment outcome; resource-limited country.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Child
  • Child, Preschool
  • Developing Countries / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Leukemia, Myeloid, Acute* / diagnosis
  • Leukemia, Myeloid, Acute* / epidemiology
  • Leukemia, Myeloid, Acute* / mortality
  • Leukemia, Myeloid, Acute* / therapy
  • Male
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Thailand / epidemiology
  • Treatment Outcome