Journal: Blood
This publication is a special report presenting consensus guidelines for the diagnosis and management of acute myeloid leukemia (AML) in children, adolescents, and young adults.
Key points:
- Rationale: Existing international guidelines for AML focus on adults and were recently updated in 2022. However, pediatric AML differs substantially from adult disease in cytogenetic and molecular landscape, clinical behavior, and treatment tolerance, necessitating dedicated, age-specific recommendations.
- Unique biology: Pediatric AML more commonly harbors distinct genetic and cytogenetic abnormalities compared with adult AML. These differences affect:
- Required diagnostic workup (including specific genetic and immunophenotypic tests).
- Risk stratification and treatment selection.
- Approaches to measurable residual disease (MRD) and response assessment.
- Scope of recommendations: An international expert panel (pediatric hematologist–oncologists, biologists, geneticists, and laboratory medicine specialists) provides:
- Guidance on optimal diagnostic evaluation in pediatric AML (including genomic testing and immunophenotyping tailored to pediatric disease).
- Recommendations for therapeutic strategies appropriate for children, adolescents, and young adults, distinct from adult protocols.
- Criteria for response assessment and MRD monitoring specific to pediatric AML.
- Supportive care strategies adapted to this age group.
- Overall goal: To standardize and improve the care of pediatric AML globally by offering harmonized, evidence-based, and biology-informed practice recommendations that complement but are separate from adult AML guidelines.