{
  "abstract": "Background: Acute myeloid leukemia (AML) with monocytic differentiation (FAB M4/M5 subtypes) is a distinct subtype of pediatric AML characterized by aggressive clinical behavior and common extramedullary involvement. Despite therapeutic advances, outcomes remain suboptimal, particularly in resource-limited settings. The study aimed to evaluate the clinical characteristics, treatment outcomes, and prognostic markers in pediatric patients with AML, FAB M4/M5 subtypes.\n\nPatients and methods: A retrospective cohort study analyzing 193 patients with AML, FAB M4/M5 subtypes diagnosed at the Children’s Cancer Hospital, Egypt-57357 (CCHE-57357) between January 2016 and December 2021.\n\nResults: The cohort comprised 131 patients with M4 and 62 with M5 morphology. Median follow-up was 62.0 months among survivors and 37.6 months for the entire cohort. Three- and five-year OS were 53.1% and 48.3%; three- and five-year EFS were 48.2% and 45.5%. Five-year CIR was 23.8%. Forty-eight patients (24.9%) died during induction. Multivariate Cox regression identified MRD positivity after first induction (HR 2.868, 95% CI 1.133–7.260, p = 0.026) and monosomy 7 (HR 6.206, 95% CI 2.692–14.306, p < 0.001) as independent adverse prognostic factors. Conversely, inv(16)(p13.1;q22) or t(16;16)(p13.1;q22); CBFB::MYH11 was an independent favorable prognostic factor (HR 0.253, 95% CI 0.108–0.592, p = 0.002). 14 high-risk pediatric AML patients underwent HSCT post-induction; three experienced adverse outcomes, comprising relapses (n = 2), and acute GVHD (n = 1).\n\nConclusion: Genetic findings and treatment response were associated with outcome, supporting a complete diagnostic assessment. Improving survival requires precise risk stratification, MRD-guided therapy, and robust supportive care.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Oncology and Nuclear Medicine, Sohag University, Sohag, Egypt",
    "Department of Pediatric Oncology, National Cancer Institute (NCI), Cairo University, Cairo, Egypt",
    "Department of Pediatric Oncology, Children’s Cancer Hospital, Cairo, Egypt",
    "Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt",
    "Department of Clinical Pathology, Children’s Cancer Hospital, Cairo, Egypt"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tarek Ahmed Abdelrehim Ahmed"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Mahmoud Hammad"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Sonya Soliman"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Nahla Elsharkawy"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Sherine Ibrahim Salem"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Sonia Ahmed"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Alaa Elhaddad"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cm7ehm35ggvd0.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1969723",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696307/",
  "id": "cm7ehm35ggvd0",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://doi.org/10.3389/fonc.2026.1969723",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2720|Acute Myeloid Leukemia Research"
    ]
  ],
  "openalex": "W7221455419",
  "pdf_url": "https://europepmc.org/articles/PMC13696307?pdf=render",
  "pmcid": "PMC13696307",
  "pmid": "42935548",
  "published": "2026-10-12",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/cm7ehm35ggvd0.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:41Z",
      "native_id": "PMC13696307",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fonc.2026.1969723"
    },
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1969723",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1969723/full"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935548",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42935548"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2234-943X",
      "subfield": "oncology"
    }
  ],
  "title": "Clinical outcomes and prognostic factors in pediatric acute myeloid leukemia with monocytic differentiation: a single-center cohort study from Egypt",
  "title_text": "Clinical outcomes and prognostic factors in pediatric acute myeloid leukemia with monocytic differentiation: a single-center cohort study from Egypt",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:40Z",
  "url": "https://research.draconitic.com/paper/cm7ehm35ggvd0",
  "venue": "Frontiers in Oncology",
  "versions": []
}