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Modern views on the treatment of acute leukemia in children under 1 year

Acute leukemias in children aged under 1 year has different clinical manifestations as compared to patients of older age groups. The prognostic values of ALL and AML in children under 1 year are different. In ALL there are additional independent risk factors which worsen the prognosis. Clinical researches in the field of infant acute leukemia is still under develop and making a significant contribution to the understanding of the biology of leukemogenesis and therapy. The results of therapy in different research groups were comprised: POG, CCG, COG (USA), JPLSG (Japan), Interfant (BFM, researchers from New Zealand, Australia and the USA). The difference of the results led to discrepancy regarding the role of allo-HSCT in the infants treatment. In Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, the 10-year OS after allo-HSCT in the pediatric group with high-risk infant leukemias was 55 %, in the group of patients with restructuring of the MLL gene – 53 % versus 59 % without MLL gene. The results of allo-HSCT depended on the disease stage at the time of treatment, in I–II CR 5-year OS was 79 % (n = 35), in III–IV CR or progression –16 % (n = 20).