Hyperleukocytosis and Access to Minimal Residual Disease Testing Impact Outcomes in Children With Newly Diagnosed Acute Myeloid Leukemia in Thailand
Issued Date
2026-01-01
Resource Type
ISSN
15455009
eISSN
15455017
Scopus ID
2-s2.0-105026896105
Pubmed ID
41496669
Journal Title
Pediatric Blood and Cancer
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pediatric Blood and Cancer (2026)
Suggested Citation
Rujkijyanont P., Ukritchon S., Winaichatsak A., Kuwatjanakul P., Chotsampancharoen T., Techavichit P., Chainansamit S.o., Sathitsamitphong L., Kanchanakamhaeng K., Anurathapan U., Laoaroon N., Wangkittikal C., Monsereenusorn C., Sanpote W., Phalakornkul N., Sripattanatadasakul P., Isaranimitkul D., Songkhla P.N., Sinlapamongkolkul P., Buaboonnam J., Pakakasama S. Hyperleukocytosis and Access to Minimal Residual Disease Testing Impact Outcomes in Children With Newly Diagnosed Acute Myeloid Leukemia in Thailand. Pediatric Blood and Cancer (2026). doi:10.1002/1545-5017.70004 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114719
Title
Hyperleukocytosis and Access to Minimal Residual Disease Testing Impact Outcomes in Children With Newly Diagnosed Acute Myeloid Leukemia in Thailand
Author(s)
Rujkijyanont P.
Ukritchon S.
Winaichatsak A.
Kuwatjanakul P.
Chotsampancharoen T.
Techavichit P.
Chainansamit S.o.
Sathitsamitphong L.
Kanchanakamhaeng K.
Anurathapan U.
Laoaroon N.
Wangkittikal C.
Monsereenusorn C.
Sanpote W.
Phalakornkul N.
Sripattanatadasakul P.
Isaranimitkul D.
Songkhla P.N.
Sinlapamongkolkul P.
Buaboonnam J.
Pakakasama S.
Ukritchon S.
Winaichatsak A.
Kuwatjanakul P.
Chotsampancharoen T.
Techavichit P.
Chainansamit S.o.
Sathitsamitphong L.
Kanchanakamhaeng K.
Anurathapan U.
Laoaroon N.
Wangkittikal C.
Monsereenusorn C.
Sanpote W.
Phalakornkul N.
Sripattanatadasakul P.
Isaranimitkul D.
Songkhla P.N.
Sinlapamongkolkul P.
Buaboonnam J.
Pakakasama S.
Author's Affiliation
Prince of Songkla University
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Ramathibodi Hospital
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Chulalongkorn University
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Vajira Hospital
Khon Kaen Regional Hospital
Bhumibol Adulyadej Hospital
Maharaj Nakhon Ratchasima Hospital
Chonburi Regional Hospital
Lampang Hospital
Prapokklao Hospital
Ratchaburi Regional Hospital
Sawanpracharak Hospital
Udon Thani Center Hospital
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Ramathibodi Hospital
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Chulalongkorn University
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Vajira Hospital
Khon Kaen Regional Hospital
Bhumibol Adulyadej Hospital
Maharaj Nakhon Ratchasima Hospital
Chonburi Regional Hospital
Lampang Hospital
Prapokklao Hospital
Ratchaburi Regional Hospital
Sawanpracharak Hospital
Udon Thani Center Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: The survival outcomes among children with acute myeloid leukemia (AML) in low- and middle-income countries are still poor despite adopting modern treatment regimens from developed countries. The study aimed to identify additional potential determinant factors for relapse and death among children with AML in Thailand. Methods: In all, data from 282 children newly diagnosed with AML between 2015 and 2019 across Thailand were retrospectively reviewed. Data, including initial white blood cell numbers, genetic analysis, post-induction minimal residual disease (MRD), hematopoietic stem cell transplantation, and supportive care, were analyzed. Results: The probability of 5-year, event-free survival, overall survival, and cumulative incidence of relapse were 40.5%, 42.3%, and 47.4%, respectively. The risk of death was significantly increased among patients stratified as high-risk AML with an adjusted hazard ratio (HR) of 1.8 (95% confidence interval [CI]: 1.1–2.9, p = 0.01). The accessibility to MRD was significantly associated with the risk of death with an adjusted HR of 1.7 (95% CI: 1.1–2.5, p = 0.01). Patients with low-risk AML did carry a significant risk for both death, with an adjusted HR of 1.8 (95% CI: 1.1–3.0, p = 0.02), and relapse, with an adjusted HR of 2.6 (95% CI: 1.5–4.7, p < 0.001) for initial WBC greater than 100,000/mm<sup>3</sup>. Conclusion: Elevated initial WBC numbers and accessibility to MRD could be considered additional risk factors for unfavorable outcomes in childhood AML.