Predisposition to prolonged neutropenia after chemotherapy for paediatric acute myeloid leukaemia is associated with better prognosis in the Japanese Paediatric Leukaemia/Lymphoma Study Group AML-05 study

Takahiro Aoki; Hiroyuki Takahashi; Shiro Tanaka; Norio Shiba; Daiichiro Hasegawa; Shotaro Iwamoto; Kiminori Terui; Hiroshi Moritake; Hideki Nakayama; Akira Shimada; Katsuyoshi Koh; Hiroaki Goto; Yoshiyuki Kosaka; Akiko M Saito; Keizo Horibe; Akitoshi Kinoshita; Akio Tawa; Takashi Taga; Souichi Adachi; Daisuke Tomizawa

doi:10.1111/bjh.16656

Predisposition to prolonged neutropenia after chemotherapy for paediatric acute myeloid leukaemia is associated with better prognosis in the Japanese Paediatric Leukaemia/Lymphoma Study Group AML-05 study

Br J Haematol. 2021 Apr;193(1):176-180. doi: 10.1111/bjh.16656. Epub 2020 Apr 26.

Authors

Takahiro Aoki¹, Hiroyuki Takahashi², Shiro Tanaka³, Norio Shiba⁴, Daiichiro Hasegawa⁵, Shotaro Iwamoto⁶, Kiminori Terui⁷, Hiroshi Moritake⁸, Hideki Nakayama⁹, Akira Shimada¹⁰, Katsuyoshi Koh¹¹, Hiroaki Goto¹², Yoshiyuki Kosaka⁵, Akiko M Saito¹³, Keizo Horibe¹³, Akitoshi Kinoshita¹⁴, Akio Tawa¹⁵, Takashi Taga¹⁶, Souichi Adachi¹⁷, Daisuke Tomizawa¹⁸

Affiliations

¹ Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan.
² Department of Pediatrics, Toho University, Tokyo, Japan.
³ Department of Clinical Biostatistics/Clinical Biostatistics Course, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁴ Department of Pediatrics, Graduate School of Medicine, Yokohama City University Hospital, Yokohama, Japan.
⁵ Department of Hematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
⁶ Department of Pediatrics, Mie University, Tsu, Japan.
⁷ Department of Pediatrics, Hirosaki University, Hirosaki, Japan.
⁸ Division of Pediatrics, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
⁹ Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
¹⁰ Department of Pediatric Hematology/Oncology, Okayama University Hospital, Okayama, Japan.
¹¹ Department of Hematology/Oncology, Saitama Children's Medical Centre, Saitama, Japan.
¹² Division of Hematology/Oncology, Kanagawa Children's Medical Centre, Yokohama, Japan.
¹³ Clinical Research Centre, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
¹⁴ Department of Pediatrics, School of Medicine, St. Marianna University, Kawasaki, Japan.
¹⁵ Higashiosaka Aramoto Heiwa Clinic, Higashiosaka, Japan.
¹⁶ Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
¹⁷ Department of Human Health Science, Kyoto University, Kyoto, Japan.
¹⁸ Division of Leukemia and Lymphoma, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.

PMID: 32337716
DOI: 10.1111/bjh.16656

Abstract

The variability in myelosuppression after chemotherapy for acute myeloid leukaemia (AML) can affect its prognosis; however, the underlying mechanism remains controversial. In the Japanese Paediatric Leukaemia/Lymphoma Study Group AML-05 study, we showed that prolonged neutropenia was associated with high overall survival (P = 0·011) and low frequency of relapse (P = 0·042) in patients without granulocyte-colony stimulating factor (G-CSF) who completed the indicated treatment protocol. Our data indicate that predisposition to prolonged neutropenia after chemotherapy is correlated with a better outcome of AML treatment. Our results promote the usage of individualised drug dosing strategies to improve the therapeutic outcome in AML patients.

Keywords: acute myeloid leukaemia; chemosensitivity; children; myelosuppression; neutropenia.

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / adverse effects*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Bone Marrow Failure Disorders / chemically induced
Child
Disease Susceptibility
Female
Granulocyte Colony-Stimulating Factor / adverse effects
Granulocyte Colony-Stimulating Factor / pharmacology*
Humans
Japan / epidemiology
Leukemia, Myeloid, Acute / drug therapy*
Leukemia, Myeloid, Acute / immunology*
Leukemia, Myeloid, Acute / mortality
Male
Neutropenia / chemically induced*
Neutropenia / epidemiology
Prognosis
Survival Analysis

Substances

Granulocyte Colony-Stimulating Factor