Infant lymphoblastic leukemia: a single centers 10 year experience

Infant acute lymphoblastic leukemia (ALL) is a rare disease and consists of4-5% of all childhood ALL. Despite improved survival rates in childhood ALL,infants with ALL have a worse prognosis. We aimed to evaluate the clinicalfeatures and treatment outcomes of our patients diagnosed with infant ALLat Hacettepe University, Pediatric Hematology Department between 1 January2008 and 1 January 2018 retrospectively.There were 13 patients with a median age of 7 months. Three of the patientswere triplets born from a spontaneous monozygotic triplet pregnancy. Relapsewere observed in 4 patients. Hematopoietic stem cell transplantation (HSCT)was performed for five patients. Relapse after HSCT was observed in 3 patients.After a median follow-up period of 18 months, 6 patients (45%) (3 after HSCTand 3 who only received chemotherapy) were alive and in remission.Prognosis of infant ALL is poor in that only half of the patients survive. Ourresults suggest that bone marrow transplantation seems to be a good andefficient choice of treatment for selected patients. However, there is still abig issue to decide which patient should undergo transplantation and morestudies are needed to reevaluate the eligibility criteria for HSCT in this groupof patients.

___

1. Kobos R, Shukla N, Armstrong SA. Infant leukemias. In: Orkin SH, Nathan DG, Ginsburg D, Look AT, Fisher DE, Lux SE. (eds). Nathan and Oski’s Hematology and Oncology of Infancy and Childhood (8th ed) Vol. 2. Philadelphia: Saunders, 2015: 1614- 1625.

2. Brown P. Treatment of infant leukemias: Challenge and promise. Hematology Am Soc Hematol Educ Program 2013; 2013: 596-600.

3. Masetti R, Rondelli R, Fagioli F, et al. Infants with acute myeloid leukemia treated according to the Associazione Italiana di Ematologia e Oncologia Pediatrica 2002/01 protocol have an outcome comparable to that of older children. Haematologica 2014; 99: e127-e129.

4. Masetti R, Vendemini F, Zama D, Biagi C, Pession A, Locatelli F. Acute myeloid leukemia in infants: Biology and treatment. Front Pediatr 2015; 3: 37.

5. Kotecha RS, Gottardo NG, Kees UR, Cole CH. The evolution of clinical trials for infant acute lymphoblastic leukemia. Blood Cancer J 2014; 4: e200.

6. Pieters R, Schrappe M, De Lorenzo P, et al. A treatment protocol for infants younger than 1 year with acute lymphoblastic leukaemia (Interfant-99): An observational study and a multicentre randomised trial. Lancet 2007; 370: 240-250.

7. Felix CA, Lange BJ. Leukemia in infants. Oncologist 1999; 4: 225-240.

8. Perez-Saldivar ML, Fajardo-Gutierrez A, SierraRamirez JA, et al; MIGICCL. Parental exposure to workplace carcinogens and the risk of development of acute leukemia in infants. Case-control study. Arch Med Res 2016; 47: 684-693.

9. Meyer C, Burmeister T, Gröger D, et al. The MLL recombinome of acute leukemias in 2017. Leukemia 2018; 32: 273-284.

10. Ibagy A, Silva DB, Seiben J, et al. Acute lymphoblastic leukemia in infants: 20 years of experience. J Pediatr (Rio J) 2013; 89: 64-69.

11. Bueno C, Montes R, Catalina P, Rodríguez R, Menendez P. Insights into the cellular origin and etiology of the infant pro-B acute lymphoblastic leukemia with MLL-AF4 rearrangement. Leukemia 2011; 25: 400-410.

12. Tomizawa D, Koh K, Hirayama M, et al. Outcome of recurrent or refractory acute lymphoblastic leukemia in infants with MLL gene rearrangements: A report from the Japan Infant Leukemia Study Group. Pediatr Blood Cancer 2009; 52: 808-813.

13. Mann G, Attarbaschi A, Schrappe M, et al; Interfant-99 Study Group. Improved outcome with hematopoietic stem cell transplantation in a poor prognostic subgroup of infants with mixed-lineageleukemia (MLL)-rearranged acute lymphoblastic leukemia: Results from the Interfant-99 Study. Blood 2010; 116: 2644-2650.

14. Silverman LB. Acute lymphoblastic leukemia in infancy. Pediatr Blood Cancer 2007; 49(7 Suppl): 1070-1073.

15. Pui CH, Gaynon PS, Boyett JM, et al. Outcome of treatment in childhood acute lymphoblastic leukaemia with rearrangements of the 11q23 chromosomal region. Lancet 2002; 359: 1909-1915.

16. Zweidler-McKay PA, Hilden JM. The ABCs of infant leukemia. Curr Probl Pediatr Adolesc Health Care 2008; 38: 78-94.

17. Doerrenberg M, Kloetgen A, Hezaveh K, et al. T-cell acute lymphoblastic leukemia in infants has distinct genetic and epigenetic features compared to childhood cases. Genes Chromosomes Cancer 2017; 56: 159-167.

18. Koh K, Tomizawa D, Moriya Saito A, et al. Early use of allogeneic hematopoietic stem cell transplantation for infants with MLL gene-rearrangement-positive acute lymphoblastic leukemia. Leukemia 2015; 29: 290-296.

19. Salzer WL, Jones TL, Devidas M, et al. Decreased induction morbidity and mortality following modification to induction therapy in infants with acute lymphoblastic leukemia enrolled on AALL0631: A report from the Children’s Oncology Group. Pediatr Blood Cancer 2015; 62: 414-418.

20. Sison EAR, Brown P. Does hematopoietic stem cell transplantation benefit infants with acute leukemia? Hematology Am Soc Hematol Educ Program 2013; 2013: 601-604.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
Sayıdaki Diğer Makaleler

Infant lymphoblastic leukemia: a single centers 10 year experience

İnci Yaman BAJİN, Selin AYTAÇ, Barış KUŞKONMAZ, Duygu Uçkan ÇETİNKAYA, Şule ÜNAL, Fatma GÜMRÜK, Mualla ÇETİN

Charcot-Marie-Tooth 1A concurrent with anaplastic ependymoma in a toddler: when an acute event unmasks a chronic condition

Maria GOGOU, Efterpi PAVLİDOU, Evangelos PAVLOU, Theodotis PAPAGEORGİOU, Athanasios TRAGİANNİDİS, Andreas GİANNOPOULOS, Emmanuel HATZİPANTELİS

The relationships between nomophobia, alexithymia and metacognitive problems in an adolescent population

Mesut YAVUZ, Beyza ALTAN, Büşra BAYRAK, Merve GÜNDÜZ, Nurullah BOLAT

Comparison between the motor function of school-aged children with normal birth weight and children with low birth weight: a cross-sectional study

Amitava PAL, Sourav MANNA, Prakash C. DHARA

Chronic recurrent multifocal osteomyelitis in children: a single center experience over five years

Erdal SAĞ, Hafize Emine SÖNMEZ, Selcan DEMİR, Yelda BİLGİNER, F. Bilge ERGEN, Üstün AYDINGÖZ, Seza ÖZEN

Acute ischemic stroke following water immersion seizure: a case report

Kamer Sing RANA, Jyotindra Narayan GOSWAMİ, Dinesh SAREEN

Excision of the atrial Wilms’ tumor thrombus without sternotomy, atriotomy and cardiovascular By-pass

Ali TEKİN, İsmail YAĞMUR, Orkan ERGÜN, Mehmet Fatih AYIK, Yüksel ATAY, İbrahim ULMAN, Ali AVANOĞLU

Comparison of neonatal reference intervals for 23 biochemical analytes in the cord blood-A single center study in South Korea

Seong Jin CHOİ, Saejin LEE, Byoungkook LEE, Jae Yun JANG, Jooyoung CHO, Young UH

Correlation of the Bayley scales of infant-toddler development-3rd edition and neuro-sensory motor assessment in preterm infants during the first year of life.

Özgün Kaya KARA, Mintaze Kerem GÜNEL, Şule YİĞİT

Concomitance of Familial Mediterranean Fever and Gitelman syndrome in an adolescent

Bahriye ATMIŞ, Rabia Miray Kışla EKİNCİ, Engin MELEK, Atıl BİŞGİN, Mustafa YILMAZ, Ali ANARAT, Aysun Karabay BAYAZIT