Bone Involvement in Pediatric Acute Myeloid Leukemia: What can we Currently Infer?

Abstract

Introduction: Acute myeloid leukemia (AML) is a clonal disease of the hematopoietic tissue characterized by abnormal proliferation of myeloid lineage progenitor cells, resulting in insufficient generation of normal mature blood cells. Bone pain is often present at the diagnosis of pediatric acute lymphoblastic leukemia but is very rare in acute myeloid leukemia. It may also indicate the presence of pathological fracture, lytic lesions, arthritis, or associated osteitis, which may delay diagnosis. Objective: To study the incidence of children with acute myeloid leukemia (AML) with bone involvement. Clinico-biological description and analysis of the prognostic impact of age, sex, treatment, type of bone involvement associated with acute myeloid leukemia. Methodology: This partly prospective/retrospective descriptive study included 17 children with AML diagnosed at the Department of Hematology and Pediatric Oncology CHU Mohamed VI Marrakech Morocco, during the period from March 2011 to November 2021. A form gathering the main items necessary for the study was made for 17 cases. Results: In order to describe the bone involvement (BA) in pediatric AML, we reviewed the records of 47 patients followed in our unit for AML. The overall incidence of OA was 36.17% or 17 cases. At diagnosis, patients had a revealing AO in 47.05% of cases, i.e. 8 cases, one of which, the diagnosis of AML was delayed by 6 months. During and after treatment, respectively 23.5% and 29.4% of patients presented bone complications (bone pain, vertebral compression, osteolysis). The average age of the patients with AO was 8.5 years. A predominance of female gender at 52.94% (9 cases). In our study, the majority of AO were resolved after AML treatments without short-term sequelae. However, a death rate was marked at 58.80% (10 cases).