January 2001, Volume 15, Issue 1, Pages 46 - 49

Original Manuscript

Extramedullary infiltrates at diagnosis have no prognostic significance in children with acute myeloid leukaemia MM Bisschop1, T Révész1,2, M Bierings1, JF van Weerden2, ER van Wering2, K Hählen2,3 & A van der Does-van den Berg2 1Department of Paediatric Haematology-Oncology, University Medical Centre, Utrecht, The Netherlands     2Dutch Childhood Leukaemia Study Group, The Hague, The Netherlands     3University Medical Centre, Rotterdam, The Netherlands     Correspondence to: T Révész, Department of Haematology-Oncology, KC.03.064, University Medical Centre, Wilhelmina Kinderziekenhuis, Postbus 85090, 3508 AB, Utrecht, The Netherlands; Fax: +31 30 250 5350

Keywords

extramedullary;   leukaemia;   myeloid;   myeloblastoma

Abstract

This retrospective study was designed to review the relative frequency and prognostic significance of extramedullary infiltrates in children with acute myeloid leukaemia (AML). The registration data and initial discharge summaries were reviewed for all children diagnosed with AML, and registered by the Dutch Childhood Leukaemia Study Group (DCLSG). Between 1972 and 1998, 477 children were diagnosed with AML. Of these patients, 120 (25.1%) had extramedullary leukaemia (EML) at diagnosis. Four categories of EML were found: skin, soft tissue or bone, gingival infiltration and central nervous system (CNS) involvement. Patients who presented with gingival infiltrates, were older than those without EML or those in the other EML subgroups, had a high initial WBC count and a high proportion of M4/M5 morphological variants. This type of presentation could indicate a special biological entity. Univariate analysis of prognostic factors in patients treated after 1985 with intensive protocols showed that initial WBC count and the presence of favourable cytogenetic findings were significant. The presence of EML at diagnosis had no significant effect on event-free survival. In a stepwise multiple regression analysis only favourable cytogenetic findings remained significant. Leukemia(2001) 15, 46-49.

Received 28 June 2000; Accepted 24 August 2000

^© Macmillan Publishers Ltd 2001