# A study of clinical profile and outcomes of paediatric patients with acute myeloid leukaemia

## TL;DR

This study examines the clinical features and treatment outcomes of children with acute myeloid leukaemia in a specific time period.

## Contribution

The study provides insights into the clinical and socio-demographic profile and outcomes of pediatric AML patients in a specific setting.

## Key findings

- The majority of patients were male, with a median age of 7 years and a high prevalence of malnutrition.
- Fever was the most common presenting symptom, and ELN risk categories were strongly associated with treatment outcomes.
- Only 47% of patients achieved remission, with 16% dying during induction and 14% abandoning treatment.

## Abstract

To describe the clinical and socio-demographic profile, as well as the induction outcomes, of paediatric patients with acute myeloid leukaemia (AML).

A retrospective analysis was conducted of patients up to 18 years of age who presented between 1 January 2017 and 31 December 2021. Patients with a diagnosis of de novo AML confirmed by flow cytometry, or with extra-medullary soft tissue masses proven to be AML by immunohistochemistry, were included. All records were obtained from the Paediatric Oncology database and supplemented by treatment files.

Among 56 patients analyzed, the male-to-female ratio was 1.15. The median age was 7 years (range: 0.2–18 years). The white blood cell (WBC) count at presentation ranged from 1,250/μL to 296,000/μL (median: 29,000/μL). Sixty percent of patients were malnourished, and the majority belonged to lower socioeconomic strata. Fever was the most common presenting symptom (93%), followed by bleeding (61%), easy fatigability (53%), bone pain (46%), hepatosplenomegaly (39%) and lymphadenopathy (14%). According to European LeukaemiaNet (ELN) 2017 risk stratification, 52% of patients were categorized as favourable risk, 18% as intermediate risk and 28% as high risk; one patient could not be risk-stratified. Remission was achieved in 47% of patients, 23% did not achieve remission, 16% died during induction and 14% abandoned treatment.

Demographic variables, nutritional status, WBC count and clinical presentations were not associated with induction outcomes, possibly due to the availability of extensive supportive care services such as accommodation near the hospital, free food and treatment and psychosocial support in the paediatric oncology unit. In contrast, ELN risk categories were strongly associated with outcomes.