Volume 43, Issue 5 pp. 1117-1122
ORIGINAL ARTICLE

Infantile leukemia—What factors determine its distinct biological nature? Clinicopathological study of 78 cases

Xin Liu

Xin Liu

Department of Pathology, Duke University Medical Center, Durham, NC, USA

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Yue Zhao

Corresponding Author

Yue Zhao

Department of Pathology, Duke University Medical Center, Durham, NC, USA

Department of Pathology, College of Basic Medical Sciences and First Affiliated Hospital, China Medical University, Shenyang, China

Correspondence

Yue Zhao, Department of Pathology, College of Basic Medical Sciences and First Affiliated Hospital, China Medical University, Shenyang 110122, China.

Emails: [email protected]; [email protected]

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Catherine Luedke

Catherine Luedke

Department of Pathology, Duke University Medical Center, Durham, NC, USA

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Rachel Jug

Rachel Jug

Department of Pathology, Duke University Medical Center, Durham, NC, USA

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Lian-He Yang

Lian-He Yang

Department of Pathology, Duke University Medical Center, Durham, NC, USA

Department of Pathology, College of Basic Medical Sciences and First Affiliated Hospital, China Medical University, Shenyang, China

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Mark Lu

Mark Lu

Department of Laboratory Medicine, University of California and Veterans Affairs Medical Center, San Francisco, CA, USA

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Zenggang Pan

Zenggang Pan

Department of Pathology, Yale University Medical Center, New Haven, CT, USA

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Dehua Wang

Dehua Wang

Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

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Robert Lorsbach

Robert Lorsbach

Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

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Yang Shi

Yang Shi

Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA

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Virginia Knez

Virginia Knez

Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA

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Catherine Rehder

Catherine Rehder

Department of Pathology, Duke University Medical Center, Durham, NC, USA

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Xiayuan Liang

Xiayuan Liang

Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA

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Endi Wang

Endi Wang

Department of Pathology, Duke University Medical Center, Durham, NC, USA

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First published: 13 April 2021

Abstract

Introduction

Infantile leukemia encompasses a heterogeneous group which needs stratifying for treatment selection.

Methods

We collected 78 cases of infantile leukemia and retrospectively analyzed their clinicopathological data.

Results

Infantile leukemia featured a ratio of acute myeloid leukemia (AML) to B-lymphoblastic leukemia (B-ALL) of 1:2, with a better survival for AML than B-ALL (median survival 36 vs 24 months). When stratified by age, “early” infantile B-ALL (2-6 months) showed a high rate of KMT2A rearrangement (100%), similar to the rate seen in congenital B-ALL (1 month) (100%) and higher than seen in “late” infantile B-ALL (≥7 months) (68%). The three categories of infantile B-ALL exhibited an age-dependent increase in survival (median survival 8.5, 24, and >24 months, respectively). The age-dependent survival benefit remained after excluding the cases negative for KMT2A rearrangement. Conversely, infantile AML lacked an age-dependent pattern of survival.

Conclusion

The clinical outcome of infantile leukemia depends on the type of leukemia. Given the age-dependent survival, infantile B-ALL can be divided into three subcategories.

CONFLICT OF INTEREST

The authors do not have any conflicts of interest to disclose.

DATA AVAILABILITY STATEMENT

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

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