The relationship between clinical and laboratory findings and prognostic factorsin pediatric patients diagnosed with acute myeloid leukemia

AIM: Despite recent improvements, the treatment outcomes of childhood acute myeloid leukemia (AML) remain inferior to those of acute lymphoblastic leukemia. This study aimed to identify factors influencing survival through a retrospective analysis. METHODS: This study included patients aged 0–18 years diagnosed with AML at our hospital from 2016 to 2023. Data were retrieved from hospital records, including clinical presentation, laboratory and imaging findings, treatment protocols, complications, and mortality causes. RESULTS: The cohort comprised 12 boys and 12 girls, with a mean diagnosis age of 7.69 years (±5.53) and a median age of 6.6 years. Two patients (8.3%) had infant AML, 2 (8.3%) had Down syndrome, and 1 (4.2%) had osteosarcoma. The AML- BFM 2013 protocol was used for 4 patients (21.1%) and AML-BFM 2019 for 15 patients (78.9%). Following the first induction, 15 patients had bone marrow blast ratios below 5%, while one exceeded 5%. Hematopoietic stem cell transplantation (HSCT) was performed in 8 patients, with one undergoing HSCT both before and after relapse. Treatment-related typhlitis was observed in 5 patients, and relapse occurred in 4. Among 21 patients with survival data, 5 (20.8%) died, including one induction-related death and four infection-related deaths. CONCLUSION: We discovered that the probability of death in infant AML patients is 21.57 times higher than in patients with other conditions. Additionally, markers such as GGT, d-dimer values, and immunophenotype markers CD117 and CD64 have shown statistically significant adverse effects on survival time. However, it's important to note that this is a single-center study, and the number of patients diagnosed with AML is relatively small, limiting our research. By investigating and identifying the factors affecting survival in more extensive case series, we can develop more targeted approaches to improve survival rates in AML patients. Keywords: Acute Myeloid Leukemia, Child, Prognosis, Retrospective, Survival Analysis