{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:19:59Z","timestamp":1777925999771,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2010,3,31]],"date-time":"2010-03-31T00:00:00Z","timestamp":1269993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The presence of central nervous system (CNS) disease in pediatric acute myeloid leukemia (AML) is often thought to confer a worse prognosis. This study examined the outcome of children with AML who had CNS disease at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients enrolled on Children's Cancer Group protocols 2861, 2891, 2941, and 2961 being treated for de novo AML were classified for the presence of CNS disease at diagnosis as CNS1 (&lt;5 WBC in the CSF without blasts), CNS2 (&lt;5 WBC in the CSF with blasts), or CNS3 (\u22655 WBC in the CSF with blasts). CNS disease at diagnosis was then analyzed regarding patient characteristics and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was an incidence of CNS disease (i.e., CNS3 status) of 11% in the 1,459 patients analyzed in this study. The risk factors found are young age, high white cell count, hepatomegaly or splenomegaly at diagnosis, M4 subtype, chromosome 16 abnormalities, and hyperdiploid cytogenetics. There were no significant differences in overall survival, event free survival, or remission rates between the groups; however, a significant difference was seen between the CNS1 and CNS3 groups in disease free survival and isolated CNS relapse risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with CNS disease at diagnosis have similar survival to those without CNS disease, although they have an increased incidence of isolated CNS relapse. Patients with CNS disease at diagnosis may warrant more aggressive CNS directed therapy. Pediatr Blood Cancer. 2010;55:414\u2013420. \u00a9 2010 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.22511","type":"journal-article","created":{"date-parts":[[2010,3,31]],"date-time":"2010-03-31T19:37:11Z","timestamp":1270064231000},"page":"414-420","source":"Crossref","is-referenced-by-count":50,"title":["The presence of central nervous system disease at diagnosis in pediatric acute myeloid leukemia does not affect survival: A Children's Oncology Group study"],"prefix":"10.1002","volume":"55","author":[{"given":"Donna L.","family":"Johnston","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A.","family":"Alonzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert B.","family":"Gerbing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly J.","family":"Lange","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William G.","family":"Woods","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,7,19]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2401971"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403920"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V66.5.1062.1062"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403131"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.6.1714"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403924"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20824"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2004.01.006"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.8.1448"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1987.5.7.1026"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22385"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.1.56"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.04.016"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-04-084293"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.4.572"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.7482"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70070-6"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2401725"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V84.2.355.355"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199903000-00004"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20951"},{"key":"e_1_2_6_23_2","first-page":"608","article-title":"Distinctive demography, biology, and outcome of acute myeloid leukemia and myelodysplasic syndrome in children with Down syndrome: Children's Cancer Group studies 2861 and 2891","volume":"91","author":"Lange BJ","year":"1998","journal-title":"Blood"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403814"},{"key":"e_1_2_6_25_2","doi-asserted-by":"crossref","first-page":"9a","DOI":"10.1182\/blood.V108.11.15.15","article-title":"Outcome of Down syndrome (DS) children with acute myeloid leukemia (AML) or myelodysplasia (MDS) treated with a uniform prospective clinical trial\u2014Initial repot of the COG trial A2971","volume":"108","author":"Gamis AS","year":"2006","journal-title":"Blood"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.08.060"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2002.03701.x"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2002.03697.x"},{"key":"e_1_2_6_29_2","first-page":"3707","article-title":"Chromosomal abnormalities in 478 children with acute myeloid leukemia: Clinical characteristics and treatment outcome in a cooperative pediatric oncology group study\u2014POG 8821","volume":"94","author":"Raimondi SC","year":"1999","journal-title":"Blood"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.12-3-341"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1990.8.1.75"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200310000-00004"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2401832"}],"container-title":["Pediatric Blood &amp; 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