Kiem Hao Tran, Van Ha Chau, Huu Son Nguyen, Nhu Hiep Pham
Pediatric Center, Hue Central Hospital, Hue, Vietnam.
Pediatr Rep. 2020 Apr 7;12(1):8486. doi: 10.4081/pr.2020.8486. eCollection 2020 Feb 11.
Acute Myeloid Leukemia (AML) in children is a serious disease. With a proper treatment, a long-term survival rate above 50% is typical. Before 2010, all the AML patients died in our hospital, and abandonment rate was more than 50%. The aims of this study are to explore the long-term outcome of newly childhood acute myeloid patients treated at Hue Central Hospital from 2010 to 2019.A retrospective study was conducted on 98 children with AML who admitted Hue Central Hospital from January 2010 to December 2019. The diagnosis was confirmed by morphological FAB criteria, cytochemistry and immunophenotype. Patients were treated with using modified AML 7-3 Regimen. Social supports were provided to patients/families. A total of 98 children with AML were analyzed with mean age of 5.6 years ranging from 3 months to 15 years. The male to female ratio was 1.8:1. The overall complete remission rate after induction were 82.6%). Patients accounted for 46 (46.9%) had relapses which occurred in during chemotherapy n=27 (27,6%), after finishing chemotherapy n=19(19,4%). Overall survival at 3 years were 23.2%. The event-free survival at 3 years were 20.2%o. Abandonment cases were 4 (4.1%). During the period study, abandonment has been reduced successfully with holistic strategies such as financial support, managing family group, providing education, early follow-up of patients who missed appointments and free accommodation near hospital for patients/families. However, with a high rate patient achieved complete remission after induction phase (82.6%), but the overal survival and event-free survival at 3 years were still low in my hospital (23.2 % and 20.2% respectively). It reflected that it was very difficult to treat successfully AML in lowand middle-income countries. We are considering the way how to improve the quality treatment for childhood acute myeloid leukemia in my hospital.
儿童急性髓系白血病（AML）是一种严重疾病。经过适当治疗，长期生存率通常超过50%。2010年之前，我院所有AML患者均死亡，放弃率超过50%。本研究旨在探讨2010年至2019年在顺化中央医院接受治疗的新发病儿童急性髓系患者的长期结局。对2010年1月至2019年12月入住顺化中央医院的98例AML儿童进行了回顾性研究。诊断通过形态学FAB标准、细胞化学和免疫表型得以确认。患者采用改良AML 7-3方案进行治疗。为患者/家庭提供了社会支持。共分析了98例AML儿童，平均年龄5.6岁，年龄范围为3个月至15岁。男女比例为1.8:1。诱导后总体完全缓解率为82.6%。46例（46.9%）患者出现复发，其中化疗期间复发27例（27.6%），化疗结束后复发19例（19.4%）。3年总生存率为23.2%。3年无事件生存率为20.2%。放弃病例有4例（4.1%）。在研究期间，通过经济支持、管理家庭群体、提供教育、对错过预约的患者进行早期随访以及为患者/家庭提供医院附近免费住宿等整体策略，放弃率已成功降低。然而，尽管诱导期后患者完全缓解率较高（82.6%），但我院3年总生存率和无事件生存率仍然较低（分别为23.2%和20.2%）。这反映出在低收入和中等收入国家成功治疗AML非常困难。我们正在考虑如何提高我院儿童急性髓系白血病的治疗质量。
