Prognostic factors for children with AML
Prognostic factors are not quite as important in predicting outcome or in guiding
treatment for AML as they are for ALL.
Age at diagnosis: Children younger than age 2 with AML seem to do better than older
children (especially teens), although age is not thought to have a strong effect on outlook.
Initial white blood cell (WBC) count: Children with AML whose WBC count is less
than 100,000 cells per cubic millimeter at diagnosis are cured more often than those with
higher counts.
Down syndrome: Children with Down syndrome who develop AML tend to have a good
outlook, especially if the child is 4 years old or younger at the time of diagnosis.
Subtype of AML: Some subtypes of AML tend to have a better outlook than others. For
example, the acute promyelocytic leukemia (APL) M3 subtype tends to have a good
outlook, while undifferentiated AML (M0) and acute megakaryoblastic leukemia (M7)
are harder to treat.
Chromosome changes: Children with leukemia cell translocations between
chromosomes 15 and 17 (seen in most cases of APL) or between 8 and 21, or with an
inversion (rearrangement) of chromosome 16 have a better chance of being cured.
Children whose leukemia cells are missing a copy of chromosome 7 (known as
monosomy 7) have a poorer prognosis.
Myelodysplastic syndrome or secondary AML: Children who first have
myelodysplastic syndrome (“smoldering leukemia”) or whose leukemia is the result of
treatment for another cancer tend to have a less favorable prognosis.
Response to treatment: Children whose leukemia responds quickly to treatment (only
one chemotherapy cycle needed to achieve remission) are more likely to be cured than
those whose leukemia takes longer to respond or does not respond at all.
Body weight: Children within the normal weight range tend to do better than children
who are underweight or overweight.
Race/ethnicity: African-American and Hispanic children with ALL tend to have a lower
cure rate than children of other races.