| Comparison of genetic and clinical aspects in patients with acute myeloid leukemia and myelodysplastic syndromes all with more than 50% of bone marrow erythropoietic cells. | |
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MedLine Citation:
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PMID: 21606170 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The World Health Organization separates acute erythroid leukemia (erythropoiesis in ≥50% of nucleated bone marrow cells; ≥20% myeloblasts of non-erythroid cells) from other entities with increased erythropoiesis - acute myeloid leukemia with myelodysplasia-related changes (≥20% myeloblasts of all nucleated cells) or myelodysplastic syndromes - and subdivides acute erythroid leukemia into erythroleukemia and pure erythroid leukemia subtypes. We aimed to investigate the biological/genetic justification for the different categories of myeloid malignancies with increased erythropoiesis (≥50% of bone marrow cells). DESIGN AND METHODS: We investigated 212 patients (aged 18.5-88.4 years) with acute myeloid leukemia or myelodysplastic syndromes characterized by 50% or more erythropoiesis: 108 had acute myeloid leukemia (77 with acute erythroid leukemia, corresponding to erythroid/myeloid erythroleukemia, 7 with pure erythroid leukemia, 24 with acute myeloid leukemia with myelodysplasia-related changes) and 104 had myelodysplastic syndromes. Morphological and chromosome banding analyses were performed in all cases; subsets of cases were analyzed by polymerase chain reaction and immunophenotyping. RESULTS: Unfavorable karyotypes were more frequent in patients with acute myeloid leukemia than in those with myelodysplastic syndromes (42.6% versus 13.5%; P<0.0001), but their frequency did not differ significantly between patients with acute erythroid leukemia (39.0%), pure erythroid leukemia (57.1%), and acute myeloid leukemia with myelodysplasia-related changes (50.0%). The incidence of molecular mutations did not differ significantly between the different categories. The 2-year overall survival rate was better for patients with myelodysplastic syndromes than for those with acute myeloid leukemia (P<0.0001), without significant differences across the different acute leukemia subtypes. The 2-year overall survival rate was worse in patients with unfavorable karyotypes than in those with intermediate risk karyotypes (P<0.0001). In multivariate analysis, only myelodysplastic syndromes versus acute myeloid leukemia (P=0.021) and cytogenetic risk category (P=0.002) had statistically significant effects on overall survival. CONCLUSIONS: The separation of acute myeloid leukemia and myelodysplastic syndromes with 50% or more erythropoietic cells has clinical relevance, but it might be worth discussing whether to replace the subclassifications of different subtypes of acute erythroid leukemia and acute myeloid leukemia with myelodysplasia-related changes by the single entity, acute myeloid leukemia with increased erythropoiesis ≥50%. |
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Authors:
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Ulrike Bacher; Claudia Haferlach; Tamara Alpermann; Wolfgang Kern; Susanne Schnittger; Torsten Haferlach |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2011-05-23 |
Journal Detail:
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Title: Haematologica Volume: 96 ISSN: 1592-8721 ISO Abbreviation: Haematologica Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-09-01 Completed Date: 2012-01-17 Revised Date: 2012-04-26 |
Medline Journal Info:
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Nlm Unique ID: 0417435 Medline TA: Haematologica Country: Italy |
Other Details:
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Languages: eng Pagination: 1284-92 Citation Subset: IM |
Affiliation:
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Department for Stem Cell Transplantation, University of Hamburg, Hamburg, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Bone Marrow Cells / pathology Cytogenetic Analysis Erythroid Cells / pathology Erythropoiesis* Female Humans Immunophenotyping Kaplan-Meier Estimate Leukemia, Myeloid, Acute / classification*, genetics, mortality, pathology Male Middle Aged Mutation / genetics Myelodysplastic Syndromes / classification*, genetics, mortality, pathology Nuclear Proteins / genetics Oncogene Proteins, Fusion / genetics Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Nuclear Proteins; 0/Oncogene Proteins, Fusion; 117896-08-9/nucleophosmin |
| Comments/Corrections | |
Comment In:
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Haematologica. 2011 Sep;96(9):1241-3
[PMID:
21880638
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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