Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan

Yung Li Yang; Tang Her Jaing; Shih Hsiang Chen; Hsi Che Liu; Iou Jih Hung; Dong Tsamn Lin; Chao Ping Yang; Ching Tien Peng; Kai Hsin Lin; Chih Cheng Hsiao; Shiann Tarng Jou; Jiann Shiuh Chen; Ming Tsan Lin; Shih Chung Wang; Te Kau Chang; Fang Liang Huang; Chao Neng Cheng; Kang Hsi Wu; Jiunn Ming Sheen; Shu Huey Chen; Meng Yao Lu; Giun Yi Hung; Hsiu Ju Yen; Yuh Lin Hsieh; Jinn Li Wang; Yu Hsiang Chang; Hsiu Hao Chang; Ting Chi Yeh; Te Fu Weng; Jen Yin Hou; Bow Wen Chen; Rong Long Chen; Lin Yen Wang; Wan Ling Ho; Yu Chieh Chen; Shin Nan Cheng; Yu Hua Chao; Shang Hsien Yang; Ting Huan Huang; Shu Wei Chou; Chien Yu Lin; Hsuan Yu Chen; Yu Mei Y. Chao; Der Cherng Liang; Tai Tsung Chang

doi:10.1038/s41598-021-85321-3

Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan

Yung Li Yang, Tang Her Jaing, Shih Hsiang Chen, Hsi Che Liu, Iou Jih Hung, Dong Tsamn Lin, Chao Ping Yang, Ching Tien Peng, Kai Hsin Lin, Chih Cheng Hsiao, Shiann Tarng Jou, Jiann Shiuh Chen, Ming Tsan Lin, Shih Chung Wang, Te Kau Chang, Fang Liang Huang, Chao Neng Cheng, Kang Hsi Wu, Jiunn Ming Sheen, Shu Huey ChenMeng Yao Lu, Giun Yi Hung, Hsiu Ju Yen, Yuh Lin Hsieh, Jinn Li Wang, Yu Hsiang Chang, Hsiu Hao Chang, Ting Chi Yeh, Te Fu Weng, Jen Yin Hou, Bow Wen Chen, Rong Long Chen, Lin Yen Wang, Wan Ling Ho, Yu Chieh Chen, Shin Nan Cheng, Yu Hua Chao, Shang Hsien Yang, Ting Huan Huang, Shu Wei Chou, Chien Yu Lin, Hsuan Yu Chen, Yu Mei Y. Chao, Der Cherng Liang, Tai Tsung Chang

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Abstract

Improvement in outcomes of children with acute myeloid leukemia (AML) is attributed to several refinements in clinical management. We evaluated treatment outcomes of Taiwanese pediatric AML patients in the past 20 years. Overall, 860 de novo AML patients aged 0–18 years and registered in the Childhood Cancer Foundation of R.O.C during January 1996–December 2019 were included. Survival analysis was performed to identify factors that improved treatment outcomes. Regardless of treatment modalities used, patients during 2008–2019 had better 5-year event-free survival (EFS) and overall survival (OS) rates than patients during 1996–2007. For patients received the TPOG-AML-97A treatment, only 5-year OS rates were significantly different between patients diagnosed before and after 2008. Patients with RUNX1–RUNX1T1 had similar relapse-free survival rates, but 5-year OS rates were better during 2008–2019. However, the survival of patients who received hematopoietic stem-cell transplantations (HSCT) did not differ significantly before and after 2008. For patients without relapse, the 5-year OS improved during 2008–2019. Non-relapse mortality decreased annually, and cumulative relapse rates were similar. In conclusion, 5-year EFS and OS rates improved during 2008–2019, though intensities of chemotherapy treatments were similar before and after 2008. Non-relapse mortality decreased gradually. Further treatment strategies including more intensive chemotherapy, novel agents’ use, identification of high-risk patients using genotyping and minimal residual disease, early intervention of HSCT, and antibiotic prophylaxis can be considered for future clinical protocol designs in Taiwan.

Original language	English
Article number	5893
Journal	Scientific reports
Volume	11
Issue number	1
DOIs	https://doi.org/10.1038/s41598-021-85321-3
Publication status	Published - 2021 Dec

All Science Journal Classification (ASJC) codes

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10.1038/s41598-021-85321-3

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Yang, Y. L., Jaing, T. H., Chen, S. H., Liu, H. C., Hung, I. J., Lin, D. T., Yang, C. P., Peng, C. T., Lin, K. H., Hsiao, C. C., Jou, S. T., Chen, J. S., Lin, M. T., Wang, S. C., Chang, T. K., Huang, F. L., Cheng, C. N., Wu, K. H., Sheen, J. M., ... Chang, T. T. (2021). Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan. Scientific reports, 11(1), Article 5893. https://doi.org/10.1038/s41598-021-85321-3

@article{1c9939db3ffa4f6aafadf6557810394d,

title = "Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan",

abstract = "Improvement in outcomes of children with acute myeloid leukemia (AML) is attributed to several refinements in clinical management. We evaluated treatment outcomes of Taiwanese pediatric AML patients in the past 20 years. Overall, 860 de novo AML patients aged 0–18 years and registered in the Childhood Cancer Foundation of R.O.C during January 1996–December 2019 were included. Survival analysis was performed to identify factors that improved treatment outcomes. Regardless of treatment modalities used, patients during 2008–2019 had better 5-year event-free survival (EFS) and overall survival (OS) rates than patients during 1996–2007. For patients received the TPOG-AML-97A treatment, only 5-year OS rates were significantly different between patients diagnosed before and after 2008. Patients with RUNX1–RUNX1T1 had similar relapse-free survival rates, but 5-year OS rates were better during 2008–2019. However, the survival of patients who received hematopoietic stem-cell transplantations (HSCT) did not differ significantly before and after 2008. For patients without relapse, the 5-year OS improved during 2008–2019. Non-relapse mortality decreased annually, and cumulative relapse rates were similar. In conclusion, 5-year EFS and OS rates improved during 2008–2019, though intensities of chemotherapy treatments were similar before and after 2008. Non-relapse mortality decreased gradually. Further treatment strategies including more intensive chemotherapy, novel agents{\textquoteright} use, identification of high-risk patients using genotyping and minimal residual disease, early intervention of HSCT, and antibiotic prophylaxis can be considered for future clinical protocol designs in Taiwan.",

author = "Yang, {Yung Li} and Jaing, {Tang Her} and Chen, {Shih Hsiang} and Liu, {Hsi Che} and Hung, {Iou Jih} and Lin, {Dong Tsamn} and Yang, {Chao Ping} and Peng, {Ching Tien} and Lin, {Kai Hsin} and Hsiao, {Chih Cheng} and Jou, {Shiann Tarng} and Chen, {Jiann Shiuh} and Lin, {Ming Tsan} and Wang, {Shih Chung} and Chang, {Te Kau} and Huang, {Fang Liang} and Cheng, {Chao Neng} and Wu, {Kang Hsi} and Sheen, {Jiunn Ming} and Chen, {Shu Huey} and Lu, {Meng Yao} and Hung, {Giun Yi} and Yen, {Hsiu Ju} and Hsieh, {Yuh Lin} and Wang, {Jinn Li} and Chang, {Yu Hsiang} and Chang, {Hsiu Hao} and Yeh, {Ting Chi} and Weng, {Te Fu} and Hou, {Jen Yin} and Chen, {Bow Wen} and Chen, {Rong Long} and Wang, {Lin Yen} and Ho, {Wan Ling} and Chen, {Yu Chieh} and Cheng, {Shin Nan} and Chao, {Yu Hua} and Yang, {Shang Hsien} and Huang, {Ting Huan} and Chou, {Shu Wei} and Lin, {Chien Yu} and Chen, {Hsuan Yu} and Chao, {Yu Mei Y.} and Liang, {Der Cherng} and Chang, {Tai Tsung}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1038/s41598-021-85321-3",

language = "English",

volume = "11",

journal = "Scientific reports",

issn = "2045-2322",

publisher = "Nature Publishing Group",

number = "1",

}

Yang, YL, Jaing, TH, Chen, SH, Liu, HC, Hung, IJ, Lin, DT, Yang, CP, Peng, CT, Lin, KH, Hsiao, CC, Jou, ST, Chen, JS, Lin, MT, Wang, SC, Chang, TK, Huang, FL, Cheng, CN, Wu, KH, Sheen, JM, Chen, SH, Lu, MY, Hung, GY, Yen, HJ, Hsieh, YL, Wang, JL, Chang, YH, Chang, HH, Yeh, TC, Weng, TF, Hou, JY, Chen, BW, Chen, RL, Wang, LY, Ho, WL, Chen, YC, Cheng, SN, Chao, YH, Yang, SH, Huang, TH, Chou, SW, Lin, CY, Chen, HY, Chao, YMY, Liang, DC & Chang, TT 2021, 'Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan', Scientific reports, vol. 11, no. 1, 5893. https://doi.org/10.1038/s41598-021-85321-3

TY - JOUR

T1 - Treatment outcomes of pediatric acute myeloid leukemia

T2 - a retrospective analysis from 1996 to 2019 in Taiwan

AU - Yang, Yung Li

AU - Jaing, Tang Her

AU - Chen, Shih Hsiang

AU - Liu, Hsi Che

AU - Hung, Iou Jih

AU - Lin, Dong Tsamn

AU - Yang, Chao Ping

AU - Peng, Ching Tien

AU - Lin, Kai Hsin

AU - Hsiao, Chih Cheng

AU - Jou, Shiann Tarng

AU - Chen, Jiann Shiuh

AU - Lin, Ming Tsan

AU - Wang, Shih Chung

AU - Chang, Te Kau

AU - Huang, Fang Liang

AU - Cheng, Chao Neng

AU - Wu, Kang Hsi

AU - Sheen, Jiunn Ming

AU - Chen, Shu Huey

AU - Lu, Meng Yao

AU - Hung, Giun Yi

AU - Yen, Hsiu Ju

AU - Hsieh, Yuh Lin

AU - Wang, Jinn Li

AU - Chang, Yu Hsiang

AU - Chang, Hsiu Hao

AU - Yeh, Ting Chi

AU - Weng, Te Fu

AU - Hou, Jen Yin

AU - Chen, Bow Wen

AU - Chen, Rong Long

AU - Wang, Lin Yen

AU - Ho, Wan Ling

AU - Chen, Yu Chieh

AU - Cheng, Shin Nan

AU - Chao, Yu Hua

AU - Yang, Shang Hsien

AU - Huang, Ting Huan

AU - Chou, Shu Wei

AU - Lin, Chien Yu

AU - Chen, Hsuan Yu

AU - Chao, Yu Mei Y.

AU - Liang, Der Cherng

AU - Chang, Tai Tsung

PY - 2021/12

Y1 - 2021/12

N2 - Improvement in outcomes of children with acute myeloid leukemia (AML) is attributed to several refinements in clinical management. We evaluated treatment outcomes of Taiwanese pediatric AML patients in the past 20 years. Overall, 860 de novo AML patients aged 0–18 years and registered in the Childhood Cancer Foundation of R.O.C during January 1996–December 2019 were included. Survival analysis was performed to identify factors that improved treatment outcomes. Regardless of treatment modalities used, patients during 2008–2019 had better 5-year event-free survival (EFS) and overall survival (OS) rates than patients during 1996–2007. For patients received the TPOG-AML-97A treatment, only 5-year OS rates were significantly different between patients diagnosed before and after 2008. Patients with RUNX1–RUNX1T1 had similar relapse-free survival rates, but 5-year OS rates were better during 2008–2019. However, the survival of patients who received hematopoietic stem-cell transplantations (HSCT) did not differ significantly before and after 2008. For patients without relapse, the 5-year OS improved during 2008–2019. Non-relapse mortality decreased annually, and cumulative relapse rates were similar. In conclusion, 5-year EFS and OS rates improved during 2008–2019, though intensities of chemotherapy treatments were similar before and after 2008. Non-relapse mortality decreased gradually. Further treatment strategies including more intensive chemotherapy, novel agents’ use, identification of high-risk patients using genotyping and minimal residual disease, early intervention of HSCT, and antibiotic prophylaxis can be considered for future clinical protocol designs in Taiwan.

AB - Improvement in outcomes of children with acute myeloid leukemia (AML) is attributed to several refinements in clinical management. We evaluated treatment outcomes of Taiwanese pediatric AML patients in the past 20 years. Overall, 860 de novo AML patients aged 0–18 years and registered in the Childhood Cancer Foundation of R.O.C during January 1996–December 2019 were included. Survival analysis was performed to identify factors that improved treatment outcomes. Regardless of treatment modalities used, patients during 2008–2019 had better 5-year event-free survival (EFS) and overall survival (OS) rates than patients during 1996–2007. For patients received the TPOG-AML-97A treatment, only 5-year OS rates were significantly different between patients diagnosed before and after 2008. Patients with RUNX1–RUNX1T1 had similar relapse-free survival rates, but 5-year OS rates were better during 2008–2019. However, the survival of patients who received hematopoietic stem-cell transplantations (HSCT) did not differ significantly before and after 2008. For patients without relapse, the 5-year OS improved during 2008–2019. Non-relapse mortality decreased annually, and cumulative relapse rates were similar. In conclusion, 5-year EFS and OS rates improved during 2008–2019, though intensities of chemotherapy treatments were similar before and after 2008. Non-relapse mortality decreased gradually. Further treatment strategies including more intensive chemotherapy, novel agents’ use, identification of high-risk patients using genotyping and minimal residual disease, early intervention of HSCT, and antibiotic prophylaxis can be considered for future clinical protocol designs in Taiwan.

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UR - http://www.scopus.com/inward/citedby.url?scp=85102528024&partnerID=8YFLogxK

U2 - 10.1038/s41598-021-85321-3

DO - 10.1038/s41598-021-85321-3

M3 - Article

C2 - 33723338

AN - SCOPUS:85102528024

SN - 2045-2322

VL - 11

JO - Scientific reports

JF - Scientific reports

IS - 1

M1 - 5893

ER -

Treatment outcomes of pediatric acute myeloid leukemia: a retrospective analysis from 1996 to 2019 in Taiwan

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