Mm. Bisschop et al., Extramedullary infiltrates at diagnosis have no prognostic significance inchildren with acute myeloid leukaemia, LEUKEMIA, 15(1), 2001, pp. 46-49
This retrospective study was designed to review the relative frequency and
prognostic significance of extramedullary infiltrates in children with acut
e myeloid leukaemia (AML), The registration data and initial discharge summ
aries were reviewed for all children diagnosed with AML, and registered by
the Dutch Childhood Leukaemia Study Group (DCLSG), Between 1972 and 1998, 4
77 children were diagnosed with AML, Of these patients, 120 (25.1%) had ext
ramedullary leukaemia (EML) at diagnosis. Four categories of EML were found
: skin, soft tissue or bone, gingival infiltration and central nervous syst
em (CNS) involvement. Patients who presented with gingival infiltrates, wer
e older than those without EML or those in the other EML subgroups, had a h
igh initial WBC count and a high proportion of M4/M5 morphological variants
. This type of presentation could indicate a special biological entity. Uni
variate analysis of prognostic factors in patients treated after 1985 with
intensive protocols showed that initial WBC count and the presence of favou
rable cytogenetic findings were significant, The presence of EML at diagnos
is had no significant effect on event-free survival, In a stepwise multiple
regression analysis only favourable cytogenetic findings remained signific
ant.