Pediatric Grand Rounds (RECORDING) Pediatric Acute Myeloid Leukemia: A Clinical Challenge

This presentation is a recording of a Stanford Pediatric Grand Rounds Session.  World-renowned experts will present the latest research, practice guidelines, and treatment protocols to advance best practices in the care of pediatric patients. These online recordings will provide pediatricians and family physicians with up-to-date clinical information on a wide range of clinical issues encountered in daily pediatric practice. 

Pediatric Acute Myeloid Leukemia (AML) is a rare malignancy in children with inferior outcomes. Genomic studies have greatly advanced our understanding of the pathogenesis of AML, however this knowledge has yet to translate into improved clinical out comes. In this session, the pathogenesis and treatment of pediatric AML is reviewed along with future directions in the field.

  Release Date: April 15, 2022
  Expiration Date: April 14, 2023
  Estimated Time to Complete: 1.0 hours 
  Registration Fee: FREE
 *Originally recorded 01/14/2022.

1. Describe the pathogenesis of pediatric AML.
2. Differentiate between pediatric at adult AML at the genomic level.
3. List three advances in the treatment of pediatric AML patients that have led to improvements in outcome.
4. Recognize the challenges of implementing immunotherapy in pediatric AML.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Cultural and Linguistic Competency
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References/Bibliography
Fornerod, M. et al. (2021). Integrative Genomic Analysis of Pediatric Myeloid-Related Acute Leukemias Identifies Novel Subtypes and Prognostic Indicators. Blood Cancer Discovery. https://aacrjournals.org/bloodcancerdiscov/article/2/6/586/665897/Integrative-GenomicAnalysis-of-Pediatric-Myeloid

Gamis, A. S., Alonzo, T. A., Meshinchi, S., Sung, L., Gerbing, R. B., Raimondi, S. C., Hirsch, B. A., Kahwash, S. B., Heerema-McKenney, A., Winter, L., Glick, K., Davies, S. M., Byron, P., Smith, F. O., & Aplenc, R. (2014). Gemtuzumab ozogamicin in children and adolescents with de novo acute myeloid leukemia improves event-free survival by reducing relapse risk: results from the randomized phase III Children’s Oncology Group trial AAML0531. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 32(27), 3021–3032. https://doi.org/10.1200/JCO.2014.55.3628

Gutierrez, A., & Kentsis, A. (2018). Acute myeloid/T-lymphoblastic leukaemia (AMTL): a distinct category of acute leukaemias with common pathogenesis in need of improved therapy. British journal of hematology, 180(6), 919–924.
https://doi.org/10.1111/bjh.15129

Khwaja, A. et al. Acute myeloid leukemia. Nat Rev Dis Primers 2, 16010 (2016). https://doi.org/10.1038/nrdp.2016.10

Kirtonia, A., Pandya, G., Sethi, G., Pandey, A. K., Das, B. C., & Garg, M. (2020). A comprehensive review of genetic alterations and molecular targeted therapies for the implementation of personalized medicine in acute myeloid leukemia. Journal of Molecular Medicine (Berlin, Germany), 98(8), 1069–1091. https://doi.org/10.1007/s00109-020-01944-5

Koreth, J., Schlenk, R., Kopecky, K. J., Honda, S., Sierra, J., Djulbegovic, B. J., Wadleigh, M., DeAngelo, D. J., Stone, R. M., Sakamaki, H., Appelbaum, F. R., Döhner, H., Antin, J. H., Soiffer, R. J., & Cutler, C. (2009). Allogeneic stem cell transplantation for acute myeloid leukemia in first complete remission: systematic review and meta-analysis of prospective clinical trials. JAMA, 301(22), 2349–2361. https://doi.org/10.1001/jama.2009.813

Mardiana, S. & Gill, S. (2020). CAR T Cells for Acute Myeloid Leukemia: State of the Art and Future Directions. Frontiers in Oncology. https://www.frontiersin.org/articles/10.3389/fonc.2020.00697/full

Rubnitz, J. E. (2012). How I treat pediatric acute myeloid leukemia. Blood. 119(25): 5980–5988. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383013/

Rubnitz, J. E., Inaba, H., Dahl, G., Ribeiro, R. C., Bowman, W. P., Taub, J., Pounds, S., Razzouk, B. I., Lacayo, N. J., Cao, X., Meshinchi, S., Degar, B., Airewele, G., Raimondi, S. C., Onciu, M., Coustan-Smith, E., Downing, J. R., Leung, W., Pui, C. H., & Campana, D. (2010). Minimal residual disease-directed therapy for childhood acute myeloid leukemia: results of the AML02 multicentre trial. The Lancet. Oncology, 11(6), 543–552. https://doi.org/10.1016/S1470-2045(10)70090-5

Wilson, A. (2012). Leukemia In The Young: Incidence and Survival Statistics.

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Mitigation of Relevant Financial Relationships

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education. 

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity, except those listed in the table below. All of the relevant financial relationships listed for these individuals have been mitigated.

Member Information

Role in activity

Nature of Relationship(s) / Name of Ineligible Company(s)

Alan R. Schroeder, MD
Clinical Professor
Stanford University

Course Director and Reviewer

Nothing to disclose

Tanja A Gruber, MD, PhD
Chambers Family Endowed Professor for Pediatric Cancer
Division Chief, Pediatric Hematology, Oncology, Stem Cell Transplantation & Regenerative Medicine
Associate Director, Childhood Cancer, Stanford Cancer Institute
Director, Bass Center for Childhood Cancer and Blood Diseases, Lucile Packard Children’s Hospital
Stanford University School of Medicine

Faculty

Consulting Fee-Kura Oncology

Debra Babcock, MD
Stanford Childrens (PCHA)

Planner

Nothing to disclose

Caitlin Billingham, MD, MPH
Chief Resident
Stanford Pediatrics

Planner

Nothing to disclose

Lisa Jo Chamberlain, MD
Professor of Pediatrics – General Pediatrics
Stanford Children's Health

Planner

Nothing to disclose

Olivera Marsenic Couloures, MD
LPCH

Planner

Nothing to disclose

Lane Donnelly, MD
University of North Carolina

Planner

Nothing to disclose

Baraka Dechelle Floyd, MD
Clinical Assistant Professor and Associate Chair for Diversity, Equity, and Inclusion
Stanford University School of Medicine

Planner

Nothing to disclose

Ingrid Garnica, Other
Stanford Pediatrics

Planner

Nothing to disclose

Charles Gawad, MD, PhD
Associate Professor
Stanford

Planner

Ownership-BioSkryb Genomics

Allison Guerin, EdD
Stanford

Planner

Nothing to disclose

Mary Beth Leonard, MD, MSCE
Arline and Pete Harman Professor and Chair, Department of Pediatrics
Stanford University

Planner

Nothing to disclose

Stephen J Roth, MPH, MD
Attending, Cardiovascular ICU
Lucile Packard Children's Hospital Stanford

Planner

Nothing to disclose

Sarina Tom, BA
Education Operations Manager
Stanford Pediatrics

Planner

Nothing to disclose

Ke-You Zhang, MD
Stanford University

Planner

Nothing to disclose