Azada Ibrahimova1, Lauren Pommert1,2, Erin H Breese3,4. 1. Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7018, Cincinnati, OH, 45229, USA. 2. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 3. Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7018, Cincinnati, OH, 45229, USA. erin.breese@cchmc.org. 4. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. erin.breese@cchmc.org.
Abstract
PURPOSE OF THE REVIEW: Infant leukemia is a rare, distinct subgroup of pediatric acute leukemias diagnosed in children under 1 year of age and characterized by unique, aggressive biology. Here, we review its clinical presentation, underlying molecular biology, current treatment strategies, and novel therapeutic approaches. RECENT FINDINGS: Infant leukemias are associated with high-risk molecular features and high rates of chemotherapy resistance. International collaborative clinical trials have led to better understanding of the underlying molecular biology, refined risk-based stratification, and investigated the use of hematopoietic stem cell transplantation. However, intensification of chemotherapy has failed to improve outcomes, and current regimens are associated with significant treatment-related and long-term toxicities. Infants with leukemia remain a challenging group to treat. We must continue collaborative efforts to move beyond traditional cytotoxic chemotherapy, incorporate molecularly targeted strategies and immunotherapy, and increase access to clinical trials to improve outcomes for this high-risk group of patients.
PURPOSE OF THE REVIEW: Infant leukemia is a rare, distinct subgroup of pediatric acute leukemias diagnosed in children under 1 year of age and characterized by unique, aggressive biology. Here, we review its clinical presentation, underlying molecular biology, current treatment strategies, and novel therapeutic approaches. RECENT FINDINGS: Infant leukemias are associated with high-risk molecular features and high rates of chemotherapy resistance. International collaborative clinical trials have led to better understanding of the underlying molecular biology, refined risk-based stratification, and investigated the use of hematopoietic stem cell transplantation. However, intensification of chemotherapy has failed to improve outcomes, and current regimens are associated with significant treatment-related and long-term toxicities. Infants with leukemia remain a challenging group to treat. We must continue collaborative efforts to move beyond traditional cytotoxic chemotherapy, incorporate molecularly targeted strategies and immunotherapy, and increase access to clinical trials to improve outcomes for this high-risk group of patients.
Authors: ZoAnn E Dreyer; Joanne M Hilden; Tamekia L Jones; Meenakshi Devidas; Naomi J Winick; Cheryl L Willman; Richard C Harvey; I-Ming Chen; Fred G Behm; Jeanette Pullen; Brent L Wood; Andrew J Carroll; Nyla A Heerema; Carolyn A Felix; Blaine Robinson; Gregory H Reaman; Wanda L Salzer; Stephen P Hunger; William L Carroll; Bruce M Camitta Journal: Pediatr Blood Cancer Date: 2014-11-14 Impact factor: 3.167
Authors: Wanda L Salzer; Tamekia L Jones; Meenakshi Devidas; ZoAnn E Dreyer; Lia Gore; Naomi J Winick; Lillian Sung; Elizabeth Raetz; Mignon L Loh; Cindy Y Wang; Paola De Lorenzo; Maria Grazia Valsecchi; Rob Pieters; William L Carroll; Stephen P Hunger; Joanne M Hilden; Patrick Brown Journal: Pediatr Blood Cancer Date: 2014-11-18 Impact factor: 3.167
Authors: J M Chessells; C J Harrison; H Kempski; D K H Webb; K Wheatley; I M Hann; R F Stevens; G Harrison; B E Gibson Journal: Leukemia Date: 2002-05 Impact factor: 11.528
Authors: U Creutzig; M Zimmermann; J-P Bourquin; M N Dworzak; B Kremens; T Lehrnbecher; C von Neuhoff; A Sander; A von Stackelberg; I Schmid; J Starý; D Steinbach; J Vormoor; D Reinhardt Journal: Leukemia Date: 2011-10-04 Impact factor: 11.528
Authors: Wanda L Salzer; Tamekia L Jones; Meenakshi Devidas; Joanne M Hilden; Naomi Winick; Stephen Hunger; William L Carroll; Bruce Camitta; ZoAnn E Dreyer Journal: Pediatr Blood Cancer Date: 2012-04-05 Impact factor: 3.167
Authors: C H Pui; S C Raimondi; D K Srivastava; X Tong; F G Behm; B Razzouk; J E Rubnitz; J T Sandlund; W E Evans; R Ribeiro Journal: Leukemia Date: 2000-04 Impact factor: 11.528
Authors: Joanne M Hilden; Patricia A Dinndorf; Sharon O Meerbaum; Harland Sather; Doojduen Villaluna; Nyla A Heerema; Ron McGlennen; Franklin O Smith; William G Woods; Wanda L Salzer; Helen S Johnstone; Zoann Dreyer; Gregory H Reaman Journal: Blood Date: 2006-03-23 Impact factor: 22.113
Authors: Amy Moskop; Lauren Pommert; Christina Baggott; Snehit Prabhu; Holly L Pacenta; Christine L Phillips; Jenna Rossoff; Heather E Stefanski; Julie-An Talano; Steve P Margossian; Michael R Verneris; G Doug Myers; Nicole A Karras; Patrick A Brown; Muna Qayed; Michelle L Hermiston; Prakash Satwani; Christa Krupski; Amy K Keating; Rachel Wilcox; Cara A Rabik; Vanessa A Fabrizio; Vasant Chinnabhandar; A Yasemin Goksenin; Kevin J Curran; Crystal L Mackall; Theodore W Laetsch; Erin M Guest; Erin H Breese; Liora M Schultz Journal: Blood Adv Date: 2022-07-26