Prognostic factors for children with Acute myeloid leukemia (AML)

Prognostic factors for children with Acute myeloid leukemia (AML)
Acute myeloid leukemia (AML) is a type of blood cancer. It usually begins in cells that would turn into white blood cells. Sometimes, though, AML can start in other types of blood-forming cells.
Acute myeloid leukemia starts in the bone marrow. This is the soft inner parts of bones.

With acute types of leukemia such as AML, bone marrow cells don't mature the way they're supposed to. These immature cells, often called blast cells, keep building up.

Causes and Risk Factors of Acute myeloid leukemia (AML)

Doctors often don’t know why someone gets AML. But they do know about some of the “risk factors” for the condition. Those are things that make you more likely get it.

Acute myeloid leukemia risk factors include:
  • Smoking
  • Exposure to certain chemicals such as benzene (a solvent used in oil refineries and other industries and present in cigarette smoke), certain cleaning products, detergents, and paint 
  • strippers
  • Some chemotherapy drugs used to treat other cancers, such as mechlorethamine, procarbazine, and chlorambucil -- especially when combined with radiation therapy
  • Exposure to high doses of radiation
  • Certain blood disorders such as myeloproliferative disorders (for example, chronic myelogenous leukemia)
  • Some birth defects and disorders, such as Down syndrome
  • Being male

Although there is no way to completely prevent AML, you may lower your risk by not smoking and avoiding exposure to chemicals.

Prognostic factors for children with Acute myeloid leukemia (AML)

Acute Lymphoid Leukemia (ALL)

Prognostic factors are not quite as important in predicting outcome or in guiding treatment for AML as they are for ALL.

1. Age at diagnosis
Children younger than age 2 with AML seem to do better than older children (especially teens), although age is not thought to have a strong effect on outlook.

2. Initial white blood cell (WBC) count
Children with AML whose WBC count is less than 100,000 cells per cubic millimeter at diagnosis are cured more often than those with higher counts.

3. Down syndrome
Children with Down syndrome who develop AML tend to have a good outlook, especially if the child is 4 years old or younger at the time of diagnosis.

4. Subtype of AML
Some subtypes of AML tend to have a better outlook than others. For example, the acute promyelocytic leukemia (APL) M3 subtype tends to have a good outlook, while undifferentiated AML (M0) and acute megakaryoblastic leukemia (M7) are harder to treat.

5. Chromosome changes
Children with leukemia cell translocations between chromosomes 15 and 17 (seen in most cases of APL) or between 8 and 21, or with an inversion (rearrangement) of chromosome 16 have a better chance of being cured. Children whose leukemia cells are missing a copy of chromosome 7 (known as monosomy 7) have a poorer prognosis.

6. Myelodysplastic syndrome or secondary AML
Children who first have myelodysplastic syndrome (“smoldering leukemia”) or whose leukemia is the result of treatment for another cancer tend to have a less favorable prognosis.

7. Response to treatment
Children whose leukemia responds quickly to treatment (only one chemotherapy cycle needed to achieve remission) are more likely to be cured than those whose leukemia takes longer to respond or does not respond at all.

8. Body weight
Children within the normal weight range tend to do better than children who are underweight or overweight.

9. Race/ethnicity
African-American and Hispanic children with ALL tend to have a lower cure rate than children of other races.

References :

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