Pediatric AML: neutrophil recovery time linked to outcomes

  • Løhmann DJA & al.
  • Pediatr Blood Cancer
  • 21 may. 2018

  • de David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In pediatric patients with acute myeloid leukemia (AML), shorter time to neutrophil recovery after first induction was associated with reduced risk for grade 3/4 infection and relapse.

Why this matters

  • High-intensity AML treatment in children is associated with neutropenia and risk for infections.

Study design

  • Study to investigate an association between neutrophil recovery time after first induction and infection and relapse in 279 pediatric patients with newly diagnosed AML.
  • Patients were treated per the NOPHO-AML 2004 or DB AML-01 protocols.
  • Funding: Danish Childhood Cancer Foundation; Danish Cancer Society; Novo Nordisk Foundation.

Key results

  • Modest association between neutrophil recovery time after first induction and neutrophil recovery time after subsequent treatment.
  • Neutrophil recovery >25 days after first induction was associated with increased risk for grade 3/4 infection during remaining treatment: HR adjusted for sex, age, and ethnicity=1.4; 95% CI, 1.1-1.8).
  • In 264 patients who did not receive hematopoietic stem cell transplantation during the first remission:
    • 118 experienced the first relapse.
    • Neutrophil recovery >30 days after first induction was associated with increased risk for relapse (HR, 1.7; 95% CI, 1.1-2.6).

Limitations

  • Complete blood counts were undertaken twice a week.
  • Sample size was underpowered for some analyses.