Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan

Abstract Improvement in outcomes of children with acute myeloid leukemia (AML) is attributed to several refinements in clinical management. We evaluated treatment outcomes of Taiwanese pediatric AML patients in the past 20 years. Overall, 860 de novo AML patients aged 0–18 years and registered in th...

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Autores principales:	Yung-Li Yang, Tang-Her Jaing, Shih-Hsiang Chen, Hsi-Che Liu, Iou-Jih Hung, Dong-Tsamn Lin, Chao-Ping Yang, Ching-Tien Peng, Kai-Hsin Lin, Chih-Cheng Hsiao, Shiann-Tarng Jou, Jiann-Shiuh Chen, Ming-Tsan Lin, Shih-Chung Wang, Te-Kau Chang, Fang-Liang Huang, Chao-Neng Cheng, Kang-Hsi Wu, Jiunn-Ming Sheen, Shu-Huey Chen, Meng-Yao Lu, Giun-Yi Hung, Hsiu-Ju Yen, Yuh-Lin Hsieh, Jinn-Li Wang, Yu-Hsiang Chang, Hsiu-Hao Chang, Ting-Chi Yeh, Te-Fu Weng, Jen-Yin Hou, Bow-Wen Chen, Rong-Long Chen, Lin-Yen Wang, Wan-Ling Ho, Yu-Chieh Chen, Shin-Nan Cheng, Yu-Hua Chao, Shang-Hsien Yang, Ting-Huan Huang, Shu-Wei Chou, Chien-Yu Lin, Hsuan-Yu Chen, Yu-Mei Y. Chao, Der-Cherng Liang, Tai-Tsung Chang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/77fd5bf286594407a22199ea9831f410
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spelling	oai:doaj.org-article:77fd5bf286594407a22199ea9831f4102021-12-02T16:31:11ZTreatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan10.1038/s41598-021-85321-32045-2322https://doaj.org/article/77fd5bf286594407a22199ea9831f4102021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85321-3https://doaj.org/toc/2045-2322Abstract Improvement in outcomes of children with acute myeloid leukemia (AML) is attributed to several refinements in clinical management. We evaluated treatment outcomes of Taiwanese pediatric AML patients in the past 20 years. Overall, 860 de novo AML patients aged 0–18 years and registered in the Childhood Cancer Foundation of R.O.C during January 1996–December 2019 were included. Survival analysis was performed to identify factors that improved treatment outcomes. Regardless of treatment modalities used, patients during 2008–2019 had better 5-year event-free survival (EFS) and overall survival (OS) rates than patients during 1996–2007. For patients received the TPOG-AML-97A treatment, only 5-year OS rates were significantly different between patients diagnosed before and after 2008. Patients with RUNX1–RUNX1T1 had similar relapse-free survival rates, but 5-year OS rates were better during 2008–2019. However, the survival of patients who received hematopoietic stem-cell transplantations (HSCT) did not differ significantly before and after 2008. For patients without relapse, the 5-year OS improved during 2008–2019. Non-relapse mortality decreased annually, and cumulative relapse rates were similar. In conclusion, 5-year EFS and OS rates improved during 2008–2019, though intensities of chemotherapy treatments were similar before and after 2008. Non-relapse mortality decreased gradually. Further treatment strategies including more intensive chemotherapy, novel agents’ use, identification of high-risk patients using genotyping and minimal residual disease, early intervention of HSCT, and antibiotic prophylaxis can be considered for future clinical protocol designs in Taiwan.Yung-Li YangTang-Her JaingShih-Hsiang ChenHsi-Che LiuIou-Jih HungDong-Tsamn LinChao-Ping YangChing-Tien PengKai-Hsin LinChih-Cheng HsiaoShiann-Tarng JouJiann-Shiuh ChenMing-Tsan LinShih-Chung WangTe-Kau ChangFang-Liang HuangChao-Neng ChengKang-Hsi WuJiunn-Ming SheenShu-Huey ChenMeng-Yao LuGiun-Yi HungHsiu-Ju YenYuh-Lin HsiehJinn-Li WangYu-Hsiang ChangHsiu-Hao ChangTing-Chi YehTe-Fu WengJen-Yin HouBow-Wen ChenRong-Long ChenLin-Yen WangWan-Ling HoYu-Chieh ChenShin-Nan ChengYu-Hua ChaoShang-Hsien YangTing-Huan HuangShu-Wei ChouChien-Yu LinHsuan-Yu ChenYu-Mei Y. ChaoDer-Cherng LiangTai-Tsung ChangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yung-Li Yang Tang-Her Jaing Shih-Hsiang Chen Hsi-Che Liu Iou-Jih Hung Dong-Tsamn Lin Chao-Ping Yang Ching-Tien Peng Kai-Hsin Lin Chih-Cheng Hsiao Shiann-Tarng Jou Jiann-Shiuh Chen Ming-Tsan Lin Shih-Chung Wang Te-Kau Chang Fang-Liang Huang Chao-Neng Cheng Kang-Hsi Wu Jiunn-Ming Sheen Shu-Huey Chen Meng-Yao Lu Giun-Yi Hung Hsiu-Ju Yen Yuh-Lin Hsieh Jinn-Li Wang Yu-Hsiang Chang Hsiu-Hao Chang Ting-Chi Yeh Te-Fu Weng Jen-Yin Hou Bow-Wen Chen Rong-Long Chen Lin-Yen Wang Wan-Ling Ho Yu-Chieh Chen Shin-Nan Cheng Yu-Hua Chao Shang-Hsien Yang Ting-Huan Huang Shu-Wei Chou Chien-Yu Lin Hsuan-Yu Chen Yu-Mei Y. Chao Der-Cherng Liang Tai-Tsung Chang Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan
description	Abstract Improvement in outcomes of children with acute myeloid leukemia (AML) is attributed to several refinements in clinical management. We evaluated treatment outcomes of Taiwanese pediatric AML patients in the past 20 years. Overall, 860 de novo AML patients aged 0–18 years and registered in the Childhood Cancer Foundation of R.O.C during January 1996–December 2019 were included. Survival analysis was performed to identify factors that improved treatment outcomes. Regardless of treatment modalities used, patients during 2008–2019 had better 5-year event-free survival (EFS) and overall survival (OS) rates than patients during 1996–2007. For patients received the TPOG-AML-97A treatment, only 5-year OS rates were significantly different between patients diagnosed before and after 2008. Patients with RUNX1–RUNX1T1 had similar relapse-free survival rates, but 5-year OS rates were better during 2008–2019. However, the survival of patients who received hematopoietic stem-cell transplantations (HSCT) did not differ significantly before and after 2008. For patients without relapse, the 5-year OS improved during 2008–2019. Non-relapse mortality decreased annually, and cumulative relapse rates were similar. In conclusion, 5-year EFS and OS rates improved during 2008–2019, though intensities of chemotherapy treatments were similar before and after 2008. Non-relapse mortality decreased gradually. Further treatment strategies including more intensive chemotherapy, novel agents’ use, identification of high-risk patients using genotyping and minimal residual disease, early intervention of HSCT, and antibiotic prophylaxis can be considered for future clinical protocol designs in Taiwan.
format	article
author	Yung-Li Yang Tang-Her Jaing Shih-Hsiang Chen Hsi-Che Liu Iou-Jih Hung Dong-Tsamn Lin Chao-Ping Yang Ching-Tien Peng Kai-Hsin Lin Chih-Cheng Hsiao Shiann-Tarng Jou Jiann-Shiuh Chen Ming-Tsan Lin Shih-Chung Wang Te-Kau Chang Fang-Liang Huang Chao-Neng Cheng Kang-Hsi Wu Jiunn-Ming Sheen Shu-Huey Chen Meng-Yao Lu Giun-Yi Hung Hsiu-Ju Yen Yuh-Lin Hsieh Jinn-Li Wang Yu-Hsiang Chang Hsiu-Hao Chang Ting-Chi Yeh Te-Fu Weng Jen-Yin Hou Bow-Wen Chen Rong-Long Chen Lin-Yen Wang Wan-Ling Ho Yu-Chieh Chen Shin-Nan Cheng Yu-Hua Chao Shang-Hsien Yang Ting-Huan Huang Shu-Wei Chou Chien-Yu Lin Hsuan-Yu Chen Yu-Mei Y. Chao Der-Cherng Liang Tai-Tsung Chang
author_facet	Yung-Li Yang Tang-Her Jaing Shih-Hsiang Chen Hsi-Che Liu Iou-Jih Hung Dong-Tsamn Lin Chao-Ping Yang Ching-Tien Peng Kai-Hsin Lin Chih-Cheng Hsiao Shiann-Tarng Jou Jiann-Shiuh Chen Ming-Tsan Lin Shih-Chung Wang Te-Kau Chang Fang-Liang Huang Chao-Neng Cheng Kang-Hsi Wu Jiunn-Ming Sheen Shu-Huey Chen Meng-Yao Lu Giun-Yi Hung Hsiu-Ju Yen Yuh-Lin Hsieh Jinn-Li Wang Yu-Hsiang Chang Hsiu-Hao Chang Ting-Chi Yeh Te-Fu Weng Jen-Yin Hou Bow-Wen Chen Rong-Long Chen Lin-Yen Wang Wan-Ling Ho Yu-Chieh Chen Shin-Nan Cheng Yu-Hua Chao Shang-Hsien Yang Ting-Huan Huang Shu-Wei Chou Chien-Yu Lin Hsuan-Yu Chen Yu-Mei Y. Chao Der-Cherng Liang Tai-Tsung Chang
author_sort	Yung-Li Yang
title	Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan
title_short	Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan
title_full	Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan
title_fullStr	Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan
title_full_unstemmed	Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan
title_sort	treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in taiwan
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/77fd5bf286594407a22199ea9831f410
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Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan

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