Patient selection: pediatric AML with relapse/recurrence
Factors associated with better overall survival:
(1) male gender
(2) autologous stem cell transplant before the relapse
(3) stem cell transplant after the relapse
(4) prolonged interval between the initial diagnosis and recurrence (each month conveys a 3% reduction in the risk of death)
where:
• The stem cell transplants after relapse appear to involve allogeneic transplants from matched sibling or matched unrelated donor.
• No specific cutoff for the time interval between diagnosis and recurrence is given. An interval less than 6 months would be associated with poor outcome and more than 2 years would be good. For the implementation I will use >= 12 months (>= 1 year recorded in Table 3, page 159). One alternative would be to consider an interval < 12 months as indicative of worse overall survival. Another alternative is to consider >= 24 as 2 points and 12-23 months as 1 point.
Factors associated with worse overall survival:
(1) FAB M5 or M7 morphology
Factors favoring a second remission:
(1) male gender
(2) FAB M1 morphology
Factors against a second remission:
(1) allogeneic stem cell transplant before relapse (all died within 1 year)
