Uncommon Cytogenetic Abnormalities Identifying High-Risk Acute Myeloid Leukemia in Children

Abstract

Pediatric acute myeloid leukemia (AML) represents an aggressive disease and is the leading cause of childhood leukemic mortality. The genomic landscape of pediatric AML has been recently mapped and redefined thanks to large-scale sequencing efforts. Today, understanding how to incorporate the growing list of genetic lesions into a risk stratification algorithm for pediatric AML is increasingly challenging given the uncertainty regarding the prognostic impact of rare lesions. Here we review some uncommon cytogenetic lesions to be considered for inclusion in the high-risk groups of the next pediatric AML treatment protocols. We describe their main clinical characteristics, biological background and outcome. We also provide some suggestions for the management of these rare but challenging patients and some novel targeted therapeutic options.

Keywords::

• cytogenetic lesions
• diagnosis
• pediatric AML
• poor prognosis
• risk stratification
• target therapy

Financial & competing interests disclosure

This work was partly supported by grants from the Associazione Italiana Ricerca sul Cancro, MFAG2016, Id. 19117, to R Masetti. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

This work was partly supported by grants from the Associazione Italiana Ricerca sul Cancro, MFAG2016, Id. 19117, to R Masetti. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.