Acute myeloid leukemia in adolescents and young adults: from the viewpoint of pediatricians.

It is well known that adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) should be treated based on pediatric ALL protocol, which could yield better survival rates. However, an optimal treatment strategy for AYAs with acute myeloid leukemia (AML) is not yet established and corresponding data are limited. Compared with ALL, clinical and biological characteristics of pediatric and adult AML are relatively similar. Moreover, treatment strategy is quite similar, although pediatric protocols are more intensive and transplant indications are narrower. Previous reports show that AYAs with AML have similar to relatively lower survival rates and higher treatment-related mortality than children with AML. These results indicated that intensive pediatric chemotherapy is effective for preventing AML relapse in AYAs but higher toxicity rates compensates overall survival. To improve the outcomes of AYAs with AML, it is essential to develop optimal intensive chemotherapy, introduce novel targeted therapies, and adopt better risk stratification, particularly to determine appropriate transplant indications. These strategies should be accomplished by close cooperation between pediatric hematologists/oncologists and adult hematologists.