Background: The reports of studies that compare the survival of adolescents and young adults with younger children with acute myeloid leukemia (AML) are contradictory. Patients and Methods: We retrospectively analyzed 220 AML patients aged 0–18 years treated in pediatric oncologic centers in Poland from 2015 to 2022. The evaluated group included 31 infants (below 1 year), 91 younger children (1–9.9 years), 59 older children (10–14.9 years), and 39 adolescents (15–18 years). Results: A 5-year overall survival for adolescents was not significantly inferior compared to younger and older children (74.3 ± 7.6% vs. 80.5 ± 4.4% vs. 77.9 ± 5.1,p= 0.243). However, relapse-free survival was lower in adolescents compared to younger children (76.5 ± 7.8% vs. 65.7 ± 9.0%,p= 0.049), and treatment-related mortality tended to be higher (10.3% vs. 4.4%,p= 0.569). In the univariate analysis, high-risk genetics [HR, 2.0 (95% CI 1.1–3.6;p= 0.014)] and a leukocyte count at diagnosis above 100,000/μL [HR, 2.4 (95% CI 1.3–4.6;p= 0.004)] were found to be unfavorable prognostic factors for survival. Conclusions: Although we have not found that age over 15 years is an unfavorable factor for overall survival, the optimal approach to therapy in adolescents, as in other age groups, is to adjust the intensity of therapy to individual genetic risk and introduce targeted therapies when indicated.
背景：关于青少年及年轻成人与低龄儿童急性髓系白血病（AML）生存率比较的研究报告存在矛盾。 患者与方法：我们回顾性分析了2015年至2022年间在波兰儿科肿瘤中心接受治疗的220例0-18岁AML患者。评估组包括31例婴儿（<1岁）、91例低龄儿童（1-9.9岁）、59例大龄儿童（10-14.9岁）及39例青少年（15-18岁）。 结果：青少年患者的5年总生存率与低龄及大龄儿童相比未见显著差异（74.3±7.6% vs. 80.5±4.4% vs. 77.9±5.1%，p=0.243）。然而，青少年的无复发生存率低于低龄儿童（76.5±7.8% vs. 65.7±9.0%，p=0.049），且治疗相关死亡率呈升高趋势（10.3% vs. 4.4%，p=0.569）。单因素分析显示，高危遗传学特征[风险比2.0（95%置信区间1.1-3.6；p=0.014）]及诊断时白细胞计数>10万/μL[风险比2.4（95%置信区间1.3-4.6；p=0.004）]是生存的不良预后因素。 结论：虽然未发现15岁以上年龄是总生存率的不良影响因素，但对青少年患者（与其他年龄组类似）的最佳治疗策略，仍需根据个体遗传风险调整治疗强度，并在有指征时引入靶向治疗。
肿瘤(癌症)患者之家