Risk groups for childhood AML

Doctors will consider all the prognostic factors for childhood acute myelogneous leukemia (AML) together to determine a level of risk or risk group. The level of risk includes the likelihood that the cancer will not respond (will be resistant) to treatment or that the cancer will come back (relapse) after treatment.

The level of risk can guide treatment plans for children with AML. Doctors use this information to determine if more or less treatment is needed. This ensures that your child is given enough treatment with the least possible side effects.

The Children’s Oncology Group (COG) has developed a risk classification system. Doctors are starting to use this system for childhood AML.

Low-risk AML has any of the following:

• translocation (rearrangement) between chromosomes 8 and 21 [t(8;21)]
• inversion in chromosome 16 [inv(16)]
• translocation between chromosomes 15 and 17 [t(15;17)]
• the presence of the nucleophosmin (NPM1) mutation
• the presence of the CEBPA mutation
• no minimal residual disease (MRD) at the end of induction chemotherapy

High-risk AML has any of the following:

• monosomy-5 or monosomy-7
• translocation or inversion in chromosome 3 [t(3;3) or inv(3)]
• t(6;9); DEK-NUP214
• NUP98 fusions
• chromosome 12p abnormalities (ETV6)
• CBFA2T3-GLIS2 fusions
• RAM phenotype
• KAT6A fusions
• the presence of the FLT3/ITD mutation
• MRD at the end of induction chemotherapy