Document Detail


Refractory anemia with excess of blasts in transformation: analysis of reclassification according to the WHO proposals.
MedLine Citation:
PMID:  12620291     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The category of "refractory anemia with excess blasts in transformation" (RAEB-T) has been abandoned in the new WHO-classification of myelodysplastic syndromes (MDS). The majority of patients previously belonging to this category are now classified as acute myeloid leukaemia (AML). In the FAB-classification, patients had been assigned to the RAEB-T category if they had either (1) a medullary blast count between 20 and 30% or (2) a peripheral blast count of at least 5%, or (3) Auer rods detectable, irrespective of the blast count. We analyzed these subtypes of RAEB-T in terms of hematological characteristics, karyotype anomalies, and prognosis. Patients with more than 20% medullary blasts and patients with at least 5% peripheral blasts as the sole defining parameter for RAEB-T had a median survival of 6 months, as compared to 11 months in patients with Auer rods as the sole defining parameter. The presence of Auer rods therefore does not convey a particularly bad prognosis and does not justify placing patients in a high-risk category of MDS or even classifying them as AML. This finding supports the elimination of Auer rods as a parameter for classification in the new WHO system. On the other hand, the reclassification into RAEB II (according to WHO proposals) of previous RAEB-T patients with a peripheral blast count of at least 5% is problematic, because this feature predicts a median survival not different from that of AML patients.
Authors:
Corinna Strupp; Norbert Gattermann; Aristoteles Giagounidis; Carlo Aul; Barbara Hildebrandt; Rainer Haas; Ulrich Germing
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Leukemia research     Volume:  27     ISSN:  0145-2126     ISO Abbreviation:  Leuk. Res.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-03-06     Completed Date:  2003-04-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7706787     Medline TA:  Leuk Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  397-404     Citation Subset:  IM    
Affiliation:
Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University, Moorenstreet 5, 40225 Düsseldorf, Germany. c.strupp@web.de
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Anemia, Refractory, with Excess of Blasts / blood,  classification*,  mortality,  pathology
Blood Cell Count
Cell Transformation, Neoplastic
Female
Humans
Inclusion Bodies / ultrastructure
Karyotyping
L-Lactate Dehydrogenase / blood
Leukemia, Myeloid / blood,  classification*,  mortality,  pathology
Life Tables
Male
Middle Aged
Myelodysplastic Syndromes / classification*
Neoplasm Proteins / blood
Neoplastic Stem Cells / pathology
Prognosis
Risk
Survival Analysis
World Health Organization
Chemical
Reg. No./Substance:
0/Neoplasm Proteins; EC 1.1.1.27/L-Lactate Dehydrogenase
Comments/Corrections
Comment In:
Leuk Res. 2003 Jul;27(7):567-9   [PMID:  12681354 ]

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