Long-term outcomes of pediatric AML in Tunisia: Lessons from 19 years of practice in Sousse.

Treating pediatric acute myeloid leukemia in resource-limited settings presents unique therapeutic challenges. This study shares 19 years of experience from a Tunisian center, focusing on practical treatment outcomes. Our pediatric AML cohort (n=68) shows 50% initial remission rates (75% with idarubicin vs 31% novantrone) and 9% induction mortality. Despite salvage therapy (43% CR2), 5-year survival remained at 33%, constrained by high relapse (53%) and limited transplant access (21%). These results highlight critical needs: optimized frontline therapy and expanded salvage options for refractory cases.