STANDARD CLINICAL PRACTICE RECOMMENDATIONS FOR ACUTE MYELOID LEUKEMIA (AML) IN CHILDREN AND ADOLESCENTS - Recommendations for diagnostics, therapy and follow-up care

Oct 3, 2026

Standard clinical practice recommendations for acute myeloid leukemia (AML) in children and adolescents cover diagnostics, treatment, and supportive care. The guidance summarizes decades of pediatric/adolescent AML treatment experience, emphasizing intensive therapy and a high risk of toxicity. It outlines prerequisites for care delivery, including rapid access to imaging, intensive care, surgery, medications, and blood products, and stresses experienced AML centers and specialist multidisciplinary management.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages50

Reading Time2 h 6 min

AccessFree to download

Background and Rationale

Background

Relapsed/refractory AML

The role of stem cell transplantation in AML

Acute promyelocytic leukemia (APL, AML FAB M3, with and w/o t(15;17)/ PML/ RARA)

Treatment related AML

AML with multiple dysplasia / AML after myelodysplastic syndrome

Acute biphenotypic leukemia, bilineage leukemia, acute leukemia of ambiguous lineage (ALAL)/Mixed phenotype acute leukemia (MPAL)

STANDARD CLINICAL PRACTICE RECOMMENDATIONS FOR ACUTE MYELOID LEUKEMIA (AML) IN CHILDREN AND ADOLESCENTS INTRODUCTORY PAGES 􀁸 Acute Myeloid Leukemia (AML) in Children and Adolescents 􀁸 Recommendations for diagnostics, therapy and follow-up care of children and adolescents with Acute Myeloid Leukemia (AML) 2020 V1 This document has been developed by: [Prof. Dr. med. Dirk Reinhardt](Prof. Dr. med. Dirk Reinhardt) Chair: AML-BFM Study Group Director EuPAL foundation (European Pediatric Acute Leukemia), Utrecht, NL University Hospital Essen, Pediatrics III Hufelandstr. 55, 45147 Essen, Germany [Dirk.reinhardt@uk-essen.de](Dirk.reinhardt@uk-essen.de) [reinhardt.dirk@aml-bfm.de](reinhardt.dirk@aml-bfm.de) Asocciate Professor Mareike Rasche University Hospital Essen, Pediatrics III Hufelandstr. 55, 45147 Essen, Germany [Mareike. Rasche@uk-essen.de](Mareike. Rasche@uk-essen.de) [Dr.med. Evangelia Antoniou](Dr.med. Evangelia Antoniou) University Hospital Essen, Pediatrics III Hufelandstr. 55, 45147 Essen, Germany [Evangelia.antoniou@uk-essen.de](Evangelia.antoniou@uk-essen.de) [Prof. Dr. med. Jan-Henning Klusmann](Prof. Dr. med. Jan-Henning Klusmann) University Hospital of Frankfurt Theodor-Stern-Kai 7, 60590, Frankfurt, Germany [j](jan-henning.klusmann@kgu.de)[an-henning.klusmann@kgu.de](jan-henning.klusmann@kgu.de) [Prof. Dr. med. Michael Dworzak](Prof. Dr. med. Michael Dworzak) Chair: AML-BFM Study Group Austria St. Anna Children's Hospital Kinderspitalgasse 6, 1090 Vienna, Austria [michael.dworzak@ccri.at](michael.dworzak@ccri.at) Planned review date 2024 PREAMBLE This recommendations/guideline include diagnostics, treatment and supportive care. The following recommendations summarize the experiences of treatment in pediatric / adolescent AML within the last 4 decades. The describe treatment is very intensive and induces a high rate of toxicities. These guidelines are based in the environment of a fully developed interdisciplinary management including the availability of every treatment option concerning 􀁸 Access to imaging including MRI, CT, ultrasound at any time 􀁸 Access to PICU 􀁸 Access to surgery (Pediatrics, Neurosurgery) 􀁸 Access to all drugs - antibiotics - anti-viral drugs - antimycotic drugs 􀁸 Access to all kind of blood products (erythrocytes/ platelets/ PBS / Immunoglobulin etc.) Treatment centers must be experienced in the therapy of AML in children and at least three pediatric hematologists/oncologists should be available. Therefore, if the experience of treating AML and conditions are not given, consider the transferal of patients to a more experienced center. This even more important in case of allogeneic stem cell transplantation! If this is not possible, consider the reduction of intensities (reduction of dosages by 1/3) and/or contact the authors Disclosure: In any case, the treating physician remains responsible for the application of any procedures and treatment to children and adolescents. DISCLAIMER: These ESCP guidance documents were produced by the relevant tumour group or specialist committee as recommendations on current best practice. The ESCP guidance documents are not clinical trial protocols. The interpretation and responsibility of the use of ESCP guidance documents lies fully with the user who retains full responsibility for the use of these guidance documents and his actions and (treatment) decisions based thereon, such as, but without limitation thereto: checking and prescribing certain doses, checking prescriptions, etc. A user should never base its decision solely on the content of these guidance documents and should always check any other relevant medical information that is available and make appropriate use of all relevant medical information. These guidance documents have been made publicly available by SIOP Europe – the European Society of Paediatric Oncology and the European Reference Network for P

FAQs

What does the guideline include for pediatric and adolescent AML care?

It includes diagnostics, treatment, and supportive care recommendations for children and adolescents with acute myeloid leukemia (AML).

Why is treatment described as highly intensive and what does that imply?

The document describes pediatric/adolescent AML treatment as very intensive, which induces a high rate of toxicities, highlighting the need for careful management and supportive care.

What care prerequisites does the guideline emphasize for treatment centers?

Treatment centers should have experience in pediatric AML therapy and at least three pediatric hematologists/oncologists. The document also stresses timely access to imaging, PICU, surgery, all drugs, and blood products.

Oct 3, 2026

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