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Impact of Cytogenetic and Molecular Genetics on the Outcome of Pediatric Acute Myeloid Leukemia: In KFSH-Dammam

Omyma Ahmed1, Hala Omer1, Esra ALmuhaimed1, Jalilah ALsadiq2, Saif El-Deen Al-Horani2, Eman Ahmed3, Saad ALdaama

Objectives: The primary aim of this study is to study cytogenetic/molecular impact on the outcome of children diagnosed and treated for acute myeloid leukemia in KFSHD, from the year 2008-2018. Secondarily to review the clinical presentation of AML in our study population and evaluate the phenotype-genotype impact on the outcome. Assess the risk stratifications. The management and response to therapy were assessed, and the complications and relapse, and overall survival rates were identified. Design: This is a retrospective cross-sectional study of all the pediatric patients below sixteen-year-old who diagnosed with acute myeloid leukemia and treated by chemotherapy alone or with allogeneic stem cell transplantation as well, in king Fahd specialist hospital in Dammam, pediatric haematology/oncology department in a decade between 1st January 2008 till end of December 2018, our study included 56 cases. Setting: It is a single center study at King Fahad Specialist Hospital in Dammam which is 400 beds tertiary referral hospital with 27 beds pediatric oncology Ward, 4 beds bone marrow transplant and 18 bed pediatric oncology day care services. Methods and Results: After obtaining the IRB approval, all data and information of patients were retrieved from patients’ hard files and electronic medical records. Data analysis were done by using Statistical Package for the Social Sciences (SPSS) program version and stored in the Redcap system for confidentiality. Results: Within our study period we diagnosed 56 cases that are diagnosed with acute myeloid leukemia and treated in king Fahad specialist hospital in Dammam. In this study the overall survival rate was around 75%, the Event free survival rate was 67% and the relapse rate was 32%. Conclusion: Pediatric AML is a clinically and genetically heterogeneous disease with a low incidence, variable survival outcomes, and high frequency of relapse, treatment-related deaths, and long-term side effects. Despite all the improvement in the outcome of childhood acute myeloid leukemia during the last decades, yet the current survival of pediatric AML is around 70%, with a further intensification of chemotherapy might not be feasible and safe. Next-Generation Sequencing (NGS) seems promising in the diagnosis and monitoring of MRD of acute myeloid leukemia. It may extend the horizon toward discovering more underlying responsible genetic aberrations that could play a role in developing new immunotherapeutic approaches and target therapies in the future. However, extra attention to the standardization of the methods of testing and interpretation is crucial. Because of the disease's rarity, national and international collaboration is significantly essential to provide adequate numbers of patients for further local and global researches in the biological, genetics, and clinical aspects and for testing modern targeted therapies.