Acute myeloid leukaemia in children

Acute myeloid leukaemia (AML) is characterized by a block in differentiatio n and an unregulated proliferation of myeloid progenitor cells. While the c ause of AML in children is unknown, risk factors that have been identified include exposure to toxins such as ethanol, pesticides and dietary topoisom erase II inhibitors, prior chemotherapy with alkylating agents or topoisome rase II inhibitors, constitutional disorders such as Down's syndrome and ty pe I neurofibromatosis, and haematopoietic failure syndromes such as Fancon i anaemia and severe congenital neutropenia. With intensified chemotherapy including high-dose Ara-C, followed in many cases by bone marrow transplant ation, and with improvements in supportive care, current survival rates app roach 50%. Future advances in paediatric AML will include better risk strat ification to determine optimal treatment and targeted cytotoxic therapy.