Introduction
About 20% of leukemia in children (of the acute type) consist of child acute myelogenous leukemia. It has a characteristic appearance under the microscope.
There are histological subtypes that have a better than average or worse than average prognosis and a hematologist can name these accurately.
It would be too confusing for the purpose of this outline to get into all that detail. Other factors associated with poor prognosis are a very young age (less than 1 year) and a high white blood cell count (more than 20,000 per cubic mm).
Child acute myelogenous leukemia treatment
Similar to remission being induced in adult AML with cytosine arabinoside (cytarabine) combined with daunorubicin or with Adriamycin, this can also be achieved in children. Alternatively, an additional one or two chemotherapy medications are added. About 75% to 85% of children with AML will get into a complete remission. However, involvement of the central nervous system appears to occur more frequently in AML than with ALL. In about 15% of children the central nervous system is involved, which causes a relapse, if it is not treated similar to what was described under ALL.
Clinically, the presentation of symptoms is very similar to ALL. However, as the prognosis for AML is significantly worse, it is important that all the proper blood tests and bone marrow samples are taken and evaluated by the hematologist and histopathologist. This is also important, because the treatment differs for the two entities. Special histology stains are used before the samples are evaluated under the microscope. Immunophenotyping is done with monoclonal antibodies.
After intensive treatments the best long-term survival is only 40% for all patients with AML, significantly less than with ALL patients. Studies are on their way to use granulocyte colony stimulating factor (G-CSF), a peptide, which is produced by white blood cells. This was first detected in tissue culture and has since been used to stimulate bone marrow growth from the stem cells that rejuvenate the bone marrow. This could be extremely helpful for combating the leukemia cancer cells during the first remission induction, where the clinician has been limited so far by the profound bone marrow suppression as a result of the chemotherapy side effects. With the help of G-CSF higher chemotherapy doses might be tolerated and higher survival rates might be achieved. Another promising line of research is the use of monoclonal antibodies in an attempt to destroy the remaining leukemia cells in the body without damaging the immune system, the bone marrow and the healthy white blood cells.
