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Paucity of data do not permit to speculate on the prognostic role of complex or monosomal karyotype in infants, while an adverse prognostic effect is evident for older children (1, 27). As already mentioned, a recently identified risk factor is the CBFA2T3-GLIS2 [http://www.selleckchem.com/products/dorsomorphin-2hcl.html Akt inhibitor] fusion transcript. Indeed, the subgroup of infants harboring this abnormality have been reported to have a significantly worse prognosis as compared with CBFA2T3-GLIS2-negative infants (EFS 32.3 vs 59.6%, P?[https://en.wikipedia.org/wiki/Ergoloid Ergoloid] and pharmacodynamic profiles of certain drugs (e.g., cytarabine) could increase the susceptibility of infants to develop toxicities (see Section ��Toxicity��), this observation translating on one hand into the need of adapting dosages of cytotoxic drugs and on the other into the opportunity that these peculiar patients be treated in centers with a recognized expertise. Similarly to what is employed in older children, an induction therapy combining antracycline and cytarabine (Ara-C) represents the backbone of initial treatment in use by many collaborative groups, while repeated courses of high-dose Ara-C in combination with other cytotoxic agents are largely used as conventional post-remission therapy. Allogeneic HSCT has been widely utilized to consolidate the state of remission also in infants, although the benefit deriving from this approach in comparison to repeated courses of chemotherapy has been questioned in recent years in view of a delicate balance between risk of relapse and late effects. CNS-directed therapy [http://www.selleckchem.com/products/AC-220.html AC220 chemical structure] does not differ from that received by older children, being based on intrathecal cytarabine injections, with dose adjusted by age. Cranial radiation has been used (4), but never under 15?months of age due to the high risk of inducing permanent severe neurological sequels. The outcome of infants with AML significantly improved over the last three decades, thanks to the intensification of therapy and the advances in risk assessment, together with the progress in supportive care (3): the EFS rate has increased from 30% in ��80s�C��90s (24, 28) to about 50�C60% in recent pediatric AML studies (4, 6, 8). The results of the most important AML trials involving infants are summarized in Table ?Table1.1. Head-to-head comparison among all these results has to be made with caution, in view of different follow-ups (from 3 to 8?years), different selection of age groups (