Evidence map›Paper›PMID 42144574›Full record

ArticleCancer medicine2026

Integrated Molecular Risk Stratification and Measurable Residual Disease-Guided Consolidation Improve Outcomes in Pediatric Non-Down Syndrome Acute Megakaryoblastic Leukemia.

Chunxia Cai, Yiqiao Chen, Chunping Wu, Xiaoqin Feng, Chunfu Li, Mincui Zheng, Huirong Mai, Lihua Yang, Hua Jiang, Xiangling He and 6 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Chunxia CaiFujian Provincial Key Laboratory on Hematology, Department of Paeditric Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
Yiqiao ChenFujian Provincial Key Laboratory on Hematology, Department of Paeditric Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
Chunping WuFujian Provincial Key Laboratory on Hematology, Department of Paeditric Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
Xiaoqin FengDepartment of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China.ORCID https://orcid.org/0000-0003-1166-0138
Chunfu LiNanfang-Chunfu Children's Institute of Hematology & Oncology, Taixin Hospital, Dongguan, China.
Mincui ZhengDepartment of Pediatric Hematology/Oncology, Hunan Children's Hospital, Changsha, China.
Huirong MaiDepartment of Pediatric Hematology/Oncology, Shenzhen Children's Hospital, Shenzhen, China.ORCID https://orcid.org/0000-0002-8970-9221
Lihua YangDepartment of Pediatrics, Zhujiang Hospital of Southern Medical University, Guangzhou, China.
Hua JiangDepartment of Pediatric Hematoloy/Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Xiangling HeDepartment of Paeditrics, People's Hospital of Hunan Province, Changsha, China.
Hong WenDepartment of Paeditrics, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Honggui XuDepartment of Paeditrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Chun ChenDepartment of Paeditrics, The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.ORCID https://orcid.org/0000-0002-5173-0439
Shaohua LeFujian Provincial Key Laboratory on Hematology, Department of Paeditric Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
Nainong LiFujian Provincial Key Laboratory on Hematology, Department of Paeditric Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.
Yongzhi ZhengFujian Provincial Key Laboratory on Hematology, Department of Paeditric Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, China.ORCID https://orcid.org/0000-0001-7882-5131

Funding

Fujian Provincial Clinical Research Center for Hematological Malignancies 2020Y2006National Key Clinical Specialty Discipline Construction Program 2021-76
6 · The paper itself

Abstract

Management of pediatric acute megakaryoblastic leukemia (AMKL) without Down syndrome (non-DS-AMKL) remains challenging due to suboptimal induction responses and poor survival. This study assessed the efficacy of fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin (FLAG-IDA) in non-DS-AMKL and evaluated the role of risk-adapted consolidation strategies, including hematopoietic stem cell transplantation (HSCT) during first complete remission (CR1), guided by genetic profiles and measurable residual disease (MRD) dynamics. In this multicenter retrospective study from China, we analyzed 58 non-DS-AMKL patients treated with FLAG-IDA (n = 50) or daunorubicin, cytarabine, etoposide (DAE) (n = 8) induction, followed by risk-adapted consolidation. FLAG-IDA demonstrated CR rates comparable to those with DAE (first-course: 70.0% vs. 87.5%, p = 0.423; cumulative: 82.0% vs. 87.5%, p = 1.000). Compared with other AML subtypes, non-DS-AMKL showed inferior 5-year overall survival (OS) (61.7% vs. 78.2%, p = 0.001) and event-free survival (EFS) (58.5% vs. 68.8%, p = 0.045), attributable to a higher relapse rate (34.8% vs. 19.5%, p = 0.002). High-risk genetics predicted worse outcomes. HSCT in CR1 significantly improved survival for high-risk or poor responders. CR with MRD negativity after second induction predicted superior OS and EFS (p < 0.001). Risk-adapted HSCT and MRD-guided stratification are critical for non-DS-AMKL management.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsConsolidation ChemotherapyLeukemia, Megakaryoblastic, AcuteAdolescentChildChild, PreschoolCytarabineDaunorubicinEtoposideFemaleGranulocyte Colony-Stimulating FactorHematopoietic Stem Cell TransplantationHumansIdarubicinInfantMaleCytarabineDaunorubicinEtoposidefludarabineGranulocyte Colony-Stimulating FactorIdarubicinVidarabineacute myeloid leukemiachemotherapyclinical observationscytogenetics

Identifiers

PMID42144574
PMCPMC13180792

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.