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<p>No conclusive reports indicate that renal function at diagnosis affects the subsequent clinical outcomes of pediatric patients with acute myeloid leukemia (AML). The present study aimed to determine the frequency of a decrease in estimated glomerular filtration rate (eGFR) at the diagnosis of AML in children, adolescents, and young adults (AYA) and its impact on patients’ clinical outcomes. We calculated the eGFR at diagnosis of 40 de novo AML patients aged 2 years or older and investigated the correlation between eGFR and clinical outcome. Decreased eGFR was defined as eGFR less than 90&#xa0;ml/min/1.73 m<sup>2</sup>. Nine (22.5%) of the 40 patients had a decreased eGFR at the time of diagnosis. Those with decreased eGFR had significantly higher white blood cell counts at diagnosis (median 76.43 × 10<sup>9</sup> vs. 9.07 × 10<sup>9</sup>/L, <i>P</i> = 0.001). The five-year event-free survival (EFS) rate in the decreased eGFR group was significantly worse than that in the normal eGFR group (22.2 vs. 77.2%, <i>P</i> &lt; 0.001). Although treatment-related mortality was similar between the two groups (28.6 vs. 11.3%, <i>P</i> = 0.223), the 5-year cumulative incidence of relapse was higher (60.0 vs. 17.5%, <i>P</i> = 0.047). Multivariate analysis of risk factors for worse EFS identified decreased eGFR as the only independent risk factor (hazard ratio, 4.785; 95% CI, 1.586–14.43; <i>P</i> = 0.005). eGFR was identified as a significant prognostic factor in this cohort, although its independence from other key markers such as minimal residual disease (MRD) remains to be established.</p>

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The Impact of Estimated Glomerular Filtration Rate at Diagnosis on Clinical Outcome in Children, Adolescents, and Young Adults with Acute Myeloid Leukemia

  • 期刊论文

  • 发表日期：

    2026年1月29日

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  • Hirozumi Sano,
  • Masato Yanagi,
  • Daiki Hori,
  • Satoru Matsushima,
  • Ryusuke Ishigaki,
  • Junjiro Ohshima,
  • Daisuke Suzuki,
  • Ryoji Kobayashi

摘要

No conclusive reports indicate that renal function at diagnosis affects the subsequent clinical outcomes of pediatric patients with acute myeloid leukemia (AML). The present study aimed to determine the frequency of a decrease in estimated glomerular filtration rate (eGFR) at the diagnosis of AML in children, adolescents, and young adults (AYA) and its impact on patients’ clinical outcomes. We calculated the eGFR at diagnosis of 40 de novo AML patients aged 2 years or older and investigated the correlation between eGFR and clinical outcome. Decreased eGFR was defined as eGFR less than 90 ml/min/1.73 m2. Nine (22.5%) of the 40 patients had a decreased eGFR at the time of diagnosis. Those with decreased eGFR had significantly higher white blood cell counts at diagnosis (median 76.43 × 109 vs. 9.07 × 109/L, P = 0.001). The five-year event-free survival (EFS) rate in the decreased eGFR group was significantly worse than that in the normal eGFR group (22.2 vs. 77.2%, P < 0.001). Although treatment-related mortality was similar between the two groups (28.6 vs. 11.3%, P = 0.223), the 5-year cumulative incidence of relapse was higher (60.0 vs. 17.5%, P = 0.047). Multivariate analysis of risk factors for worse EFS identified decreased eGFR as the only independent risk factor (hazard ratio, 4.785; 95% CI, 1.586–14.43; P = 0.005). eGFR was identified as a significant prognostic factor in this cohort, although its independence from other key markers such as minimal residual disease (MRD) remains to be established.