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Pediatric Acute Myelocytic Leukemia Differential Diagnoses

  • Author: Mark E Weinblatt, MD; Chief Editor: Jennifer Reikes Willert, MD  more...
 
Updated: Mar 31, 2016
 
 

Diagnostic Considerations

Children may not have well-known symptoms of leukemia, such as adenopathy, overt bleeding, and serious infections. Nonspecific symptoms, such as fatigue, irritability, fevers, and bruising, are common in childhood and might not be recognized as symptoms of leukemia, thus delaying a diagnosis of leukemia. Persistence of these symptoms should prompt further investigation.

Differentials in the diagnosis of acute myeloid leukemia, aside from those listed in the next section, include the following:

  • Aplastic anemia
  • Drug-induced pancytopenia
  • Viral-induced pancytopenia
  • Systemic lupus erythematosus
  • Neuroblastoma
  • Transient myeloproliferative syndrome in Down syndrome

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Mark E Weinblatt, MD Chief, Division of Pediatric Hematology/Oncology, Professor of Clinical Pediatrics, Department of Pediatrics, Winthrop University Hospital

Mark E Weinblatt, MD is a member of the following medical societies: American Society of Hematology, American Society of Pediatric Hematology/Oncology, American Society of Clinical Oncology

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Timothy P Cripe, MD, PhD, FAAP Chief, Division of Hematology/Oncology/BMT, Gordon Teter Endowed Chair in Pediatric Cancer, Nationwide Children's Hospital; Professor of Pediatrics, Ohio State University College of Medicine

Timothy P Cripe, MD, PhD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association for the Advancement of Science, American Association for Cancer Research, American Pediatric Society, American Society of Gene and Cell Therapy, American Society of Pediatric Hematology/Oncology, Connective Tissue Oncology Society, Society for Pediatric Research, Children's Oncology Group

Disclosure: Nothing to disclose.

Chief Editor

Jennifer Reikes Willert, MD Associate Clinical Professor, Department of Pediatrics, Division of Pediatric Hematology/Oncology, Section of Stem Cell Transplantation, Stanford University Medical Center, Lucile Packard Children's Hospital

Jennifer Reikes Willert, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Hematology, American Society for Blood and Marrow Transplantation, Children's Oncology Group, American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Additional Contributors

Kathleen M Sakamoto, MD, PhD Shelagh Galligan Professor, Division of Hematology/Oncology, Department of Pediatrics, Stanford University School of Medicine

Kathleen M Sakamoto, MD, PhD is a member of the following medical societies: International Society for Experimental Hematology, American Society of Hematology, American Society of Pediatric Hematology/Oncology, Society for Pediatric Research

Disclosure: Nothing to disclose.

References
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  3. Matasar MJ, Ritchie EK, Consedine N, Magai C, Neugut AI. Incidence rates of acute promyelocytic leukemia among Hispanics, blacks, Asians, and non-Hispanic whites in the United States. Eur J Cancer Prev. 2006 Aug. 15(4):367-70. [Medline].

  4. [Guideline] Tomizawa D, Tabuchi K, Kinoshita A, Hanada R, Kigasawa H, Tsukimoto I, et al. Repetitive cycles of high-dose cytarabine are effective for childhood acute myeloid leukemia: long-term outcome of the children with AML treated on two consecutive trials of Tokyo Children's Cancer Study Group. Pediatr Blood Cancer. 2007 Aug. 49(2):127-32. [Medline].

  5. Imamura T, Iwamoto S, Kanai R, Shimada A, Terui K, Osugi Y, et al. Outcome in 146 patients with paediatric acute myeloid leukaemia treated according to the AML99 protocol in the period 2003-06 from the Japan Association of Childhood Leukaemia Study. Br J Haematol. 2012 Aug 28. [Medline].

  6. Gamis AS, Woods WG, Alonzo TA, Buxton A, Lange B, Barnard DR, et al. Increased age at diagnosis has a significantly negative effect on outcome in children with Down syndrome and acute myeloid leukemia: a report from the Children's Cancer Group Study 2891. J Clin Oncol. 2003 Sep 15. 21(18):3415-22. [Medline].

  7. Ortega JJ, Madero L, Martín G, Verdeguer A, García P, Parody R, et al. Treatment with all-trans retinoic acid and anthracycline monochemotherapy for children with acute promyelocytic leukemia: a multicenter study by the PETHEMA Group. J Clin Oncol. 2005 Oct 20. 23(30):7632-40. [Medline].

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  9. [Guideline] Children's Oncology Group. Chemotherapy. Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers. Mar 2006.

  10. Harding A. One-third cure rate in first-ever pediatric relapsed AML trial. Medscape Medical News. January 18, 2013. Available at http://www.medscape.com/viewarticle/777872. Accessed: January 28, 2013.

  11. Kaspers GJ, Zimmermann M, Reinhardt D, et al. Improved Outcome in Pediatric Relapsed Acute Myeloid Leukemia: Results of a Randomized Trial on Liposomal Daunorubicin by the International BFM Study Group. J Clin Oncol. 2013 Jan 14. [Medline].

  12. Lie SO, Abrahamsson J, Clausen N, Forestier E, Hasle H, Hovi L, et al. Treatment stratification based on initial in vivo response in acute myeloid leukaemia in children without Down's syndrome: results of NOPHO-AML trials. Br J Haematol. 2003 Jul. 122(2):217-25. [Medline].

  13. Sanz MA, Grimwade D, Tallman MS, Lowenberg B, Fenaux P, Estey EH, et al. Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet. Blood. 2009 Feb 26. 113(9):1875-91. [Medline].

  14. [Guideline] Children's Oncology Group. Hematopoetic cell transplant. Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers. Mar 2006.

  15. Klingebiel T, Reinhardt D, Bader P. Place of HSCT in treatment of childhood AML. Bone Marrow Transplant. 2008 Oct. 42 Suppl 2:S7-9. [Medline].

  16. Richardson PG, Riches ML, Kernan NA, Brochstein JA, Mineishi S, Termuhlen AM, et al. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood. 2016 Jan 29. [Medline]. [Full Text].

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  18. Creutzig U, Zimmermann M, Bourquin JP, Dworzak MN, Fleischhack G, Graf N, et al. Randomized trial comparing liposomal daunorubicin with idarubicin in induction for pediatric acute myeloid leukemia: results from Study AML-BFM 2004. Blood. 2013 May 23. [Medline].

  19. Johnson K. Less cardiotoxicity in pediatric AML. Medscape Medical News. May 30, 2013. [Full Text].

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