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CNS relapse
Source: Childhood Acute Myeloid Leukemia Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 15, 2025 · Captured 2026-09-09.
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Context: Treatment of Recurrent or Refractory Childhood AML / Recurrent Childhood AML
Isolated CNS relapse occurs in 3% to 6% of pediatric patients with AML.[51-53] Factors associated with an increased risk of isolated CNS relapse include the following:[51]
Age younger than 2 years at initial diagnosis.
M5 leukemia.
11q23 abnormalities.
CNS2 or CNS3 involvement at initial diagnosis.[53]
Source links and citations
The risk of CNS relapse increases with more CNS leukemic involvement at initial AML diagnosis (CNS1: 0.6%, CNS2: 2.6%, CNS3: 5.8% incidence of isolated CNS relapse, P < .001; multivariate HR for CNS3: 7.82, P = .0003).[53] The outcome of isolated CNS relapse when treated as a systemic relapse is similar to that of bone marrow relapse. In one study, the 8-year OS rate for a cohort of children with an isolated CNS relapse was 26% (± 16%).[51] Concurrent bone marrow and CNS relapses can occur, and the incidence increases with CNS involvement at diagnosis (CNS1: 2.7%, CNS2: 8.5%, CNS3: 9.2%, P < .001).[53]
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Preserved source evidence · Not medical advice