Minimally differentiated acute myeloid leukemia (FAB AML-M0) is associated with an adverse outcome in children: A report from the Children's Oncology Group, studies CCG-2891 and CCG-2961

Draga Barbaric, Todd A. Alonzo, Robert B. Gerbing, Soheil Meshinchi, Nyla A. Heerema, Dorothy R. Barnard, Beverly J. Lange, William G. Woods, Robert J. Arceci, Franklin O. Smith

Research output: Contribution to journalArticle

Abstract

To assess the impact of minimally differentiated acute myeloid leukemia (AML-M0) morphology in children, we analyzed 2 sequential Children's Cancer Group AML clinical trials. We compared presenting characteristics and outcomes of 82 CCG-2891 and CCG-2961 patients with de novo, non-Down syndrome (DS) AML-M0 with those of 1620 patients with non-M0 AML, and of 10 CCG-2891 patients with DS-associated AML-M0 with those of 179 with DS-associated non-M0 AML. Morphology and cytogenetics were centrally reviewed. The non-DS AML-M0 children had a lower white blood cell (WBC) count (P = .001) than their non-M0 counterparts and a higher incidence of chromosome 5 deletions (P = .002), nonconstitutional trisomy 21 (P = .027), and hypodiploidy (P = .002). Outcome analyses considering all children with non-DS AML demonstrated no significant differences between M0 and non-M0 patients. Analyses restricted to intensive-timing CCG-2891 and CCG-2961 demonstrated comparable complete response (CR) rates (79% and 78%) between non-DS M0 and non-M0 patients. Overall survival (OS) from diagnosis (38% ± 14% versus 51% ± 3%; P = .160) was not significantly different between the 2 groups. OS from end of induction (45% ± 17% versus 63% ± 3%; P = .038), event-free survival (EFS; 23% ± 11% versus 41% ± 3%; P = .018), and disease-free survival (DFS; 31% ± 14% versus 52% ± 3%; P = .009) were inferior in the M0 group. There was no significant outcome difference between DS-associated AML-M0 and non-M0 children. This study suggests that intensively treated non-DS-associated AML-M0 children have an inferior outcome compared with children with non-M0 AML.

Original languageEnglish (US)
Pages (from-to)2314-2321
Number of pages8
JournalBlood
Volume109
Issue number6
DOIs
StatePublished - Mar 15 2007

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Barbaric, D., Alonzo, T. A., Gerbing, R. B., Meshinchi, S., Heerema, N. A., Barnard, D. R., Lange, B. J., Woods, W. G., Arceci, R. J., & Smith, F. O. (2007). Minimally differentiated acute myeloid leukemia (FAB AML-M0) is associated with an adverse outcome in children: A report from the Children's Oncology Group, studies CCG-2891 and CCG-2961. Blood, 109(6), 2314-2321. https://doi.org/10.1182/blood-2005-11-025536