A multicenter experience from Lebanon in childhood and adolescent acute myeloid leukemia

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dc.contributor.author Farhat, Hussein Z.
dc.contributor.author Farah, Roula A.
dc.contributor.author Horkos, Jessy G.
dc.contributor.author Bustros, Youssef D.
dc.contributor.author Abla, Oussama
dc.date.accessioned 2019-05-03T06:57:07Z
dc.date.available 2019-05-03T06:57:07Z
dc.date.copyright 2015 en_US
dc.date.issued 2019-05-03
dc.identifier.issn 2035-3006 en_US
dc.identifier.uri http://hdl.handle.net/10725/10527
dc.description.abstract Background Acute myeloid leukemia (AML) is a disease with marked heterogeneity. Despite major improvement in outcome, it remains a life-threatening malignancy. Demographic and clinical data on pediatric AML is lacking among the Lebanese population. Purpose We aimed to identify clinical, molecular and outcome data in children with AML in Lebanon. Methods A retrospective chart review of children with AML diagnosed in three Lebanese hospitals during the past 8 years was conducted. Results From May 2002 through March 2010, we identified 24 children with AML in Saint George Hospital University Medical Center, University Medical Center Rizk Hospital, and Abou-Jaoude Hospital. Males and females were equally represented; median age at diagnosis was 9 years (range 1–24) and median WBC at diagnosis was 31 × 109/L (range: 2.1–376 × 109/L). Twenty five percent of patients (6 out of 24) had acute promyelocytic leukemia (APL). Karyotype was normal in 33% of patients; t(8;21), inv (16), t(8;9), t(7;11), t(9;11), complex chromosomal abnormality, monosomy 7 and trisomy 8 were the most common cytogenetic abnormalities encountered. Patients were treated on different European and North American protocols. Twelve patients (50%) achieved morphologic CR after cycle 1, 6 of them (50%) had bone marrow relapse within 11 months from diagnosis. Nine patients underwent allogeneic stem cell transplant, and 3 of them are alive at 5 years post-transplant. Early death rate was 16.6% of patients, mainly those with APL and a presenting WBC > 10 × 109/L. Fifty per cent of APL patients had an early death due to DIC despite starting ATRA therapy. Overall, median survival for AML patients who died from disease progression was 25.8 months (range: 1–60 months). Overall disease-free survival was 30.4%. Patients < 10 years of age had a 50% survival rate compared to 0% in patients > 10 years. Conclusions Our report highlights the needs in Lebanon for better supportive care of children with APL, including faster ATRA administration and, aggressive transfusions, easy access to stem cell transplant for high-risk AML patients and the need for a national homogenous treatment strategy for children with AML. en_US
dc.language.iso en en_US
dc.title A multicenter experience from Lebanon in childhood and adolescent acute myeloid leukemia en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle high rate of early death in childhood acute promyelocytic leukemia en_US
dc.author.school SOM en_US
dc.author.idnumber 201004804 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Mediterranean journal of hematology and infectious diseases en_US
dc.journal.volume 7 en_US
dc.journal.issue 1 en_US
dc.article.pages e2015012 en_US
dc.identifier.doi http://dx.doi.org/10.4084/MJHID.2015.012 en_US
dc.identifier.ctation Farah, R. A., Horkos, J. G., Bustros, Y. D., Farhat, H. Z., & Abla, O. (2015). A multicenter experience from Lebanon in childhood and adolescent acute myeloid leukemia: high rate of early death in childhood acute promyelocytic leukemia. Mediterranean journal of hematology and infectious diseases, 7(1). en_US
dc.author.email hussein.farhat@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283923/ en_US
dc.author.affiliation Lebanese American University en_US

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