Volume 70, Issue 7 , Pages 269-273, July 2007
Clinicopathologic Analysis of Acute Myeloid Leukemia in a Single Institution: Biphenotypic Acute Myeloid Leukemia May Not Be an Aggressive Subtype
Article Outline
Background
Most acute leukemias are classified as lymphoid or myeloid lineages by standard microscopic morphology, cytochemistry and a panel of immunologic markers. The World Health Organization classification of acute leukemia incorporates morphologic, cytogenetic, immunologic and clinical features to define the entities that are biologically homogeneous and that have clinical relevance. The purpose of this study was to determine the clinicopathologic characteristics of acute myeloid leukemia (AML) in Taiwan.
Methods
Archival tissues from 70 AML patients during the period of 1995 to 2003 were retrieved. Histologic subtype was classified, defined by World Health Organization classification. Clinical data, including age, gender, treatment and outcome, were scrutinized.
Results
There were 37 males and 33 females. The median age at onset of disease was 49 years (range, 2–78 years), which was younger in biphenotypic AML (23.5 years) and older in multilineage dysplasia-related AML (61 years). There were 9 cases (13%) with recurrent cytogenetic abnormality, 7 (10%) multilineage dysplasia-related, 7 (10%) therapy-related, 39 (56%) not other categorized and 8 (11%) of ambiguous lineage. The 2-and 5-year overall survival rates of AML were 26.5% and 20.6%, respectively. Histologic subtype was a significant parameter to determine survival (p < 0.05). The median survivals of therapy-related, multilineage dysplasia-related and biphenotypic AML were 2 months, 9 months and 30.5 months, respectively.
Conclusion
This was a clinicopathologic study of AML in Taiwan. Histologic subtype plays a significant prognostic role. Multilineage dysplasia-and therapy-related AML have worse prognosis. Biphenotypic AML may not be an aggressive subtype.
Key Words: acute myeloid leukemia , biphenotypic , multilineage dysplasia , therapy-related , WHO classification
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References
- The reliability and specificity of c-kit for the diagnosis of acute myeloid leukemias and undifferentiated leukemias. The European Group for the Immunological Classification of Leukemias (EGIL) . Blood . 1998;92:596–599
- . Proposals for the immunological classification of acute leukemias. European Group for the Immunological Characterization of Leukemias (EGIL) . Leukemia . 1995;9:1783–1786
- . Proposed revised criteria for the classification of acute myeloid leukemia: A report of the French–American–British Cooperative group . Ann Intern Med . 1985;103:620–625
- . World Health Organization Classification of Tumours. Tumours of Hematopoietic and Lymphoid Tissues . Lyon: LARC Press; 2001;
- The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children's Leukemia Working Party . Blood . 1998;92:2322–2333
- Correlation of cytogenetic results with immunophenotype, genotype, clinical features and ras mutation in acute myeloid leukemia: a study of 235 Chinese patients in Taiwan . Cancer Genet Cytogenet . 1995;84:60–68
- Improved treatment results for childhood acute myeloid leukemia in Taiwan . Leukemia . 2006;20:136–141
- . Intravenous busulfan as preparative regimen in pediatric patients receiving hematopoietic stem cell transplantation: the preliminary experience in Taiwan . J Chin Med Assoc . 2004;67:117–122
- . Lactate dehydrate, not vascular endothelial growth factor or basic fibroblast growth factor, positively correlates to bone marrow vascularity in acute myeloid leukemia . J Chin Med Assoc . 2006;69:534–537
- International scoring system for evaluating prognosis in myelodysplastic syndromes . Blood . 1997;89:2079–2088
- . The secondary leukemias: challenges and research directions . J Natl Cancer Inst . 1996;88:407–418
- . Therapy-related acute myelogenous leukemia associated with 11q23 chromosomal abnormalities and topoisomerase II inhibitors: report of four additional cases and brief commentary . Leuk Lymphoma . 1993;11:141–145
- Secondary leukemia and myelodysplasia without abnormalities of chromosome 11q23 following treatment of acute leukemia with topoisomerase II-based chemotherapy . Leukemia . 2001;15:963–970
- . Lineage commitment in biphenotypic acute leukemia . Leukemia . 1993;7:919–927
- Outcome of biphenotypic acute leukemia . Haematologica . 1999;84:699–706
- Adult biphenotypic acute leukemia: an entity with poor prognosis which is related to unfavorable cytogenetics and p-glycoprotein over-expression . Br J Haematol . 1998;100:147–155
- . Definition of acute biphenotypic leukemia . Haematologica . 1997;82:64–66
PII: S1726-4901(07)70003-5
doi:10.1016/S1726-4901(07)70003-5
© 2007 Elsevier. All rights reserved.
Volume 70, Issue 7 , Pages 269-273, July 2007
