Korean J Lab Med.  2010 Jun;30(3):231-238. 10.3343/kjlm.2010.30.3.231.

Clinical Importance of Morphological Multilineage Dysplasia in Acute Myeloid Leukemia with Myelodysplasia Related Changes

• Park SH
• Chi HS
• Park SJ
• Jang S
• Park CJ

• KMID: 1781620
• DOI: http://doi.org/10.3343/kjlm.2010.30.3.231

Abstract

BACKGROUND
AML with myelodysplasia related changes (AML MRC) is known to show a poor prognosis compared with de novo AML, but controversies exist about the prognostic impact of multilineage dysplasia (MLD) among MRC. We investigated the prognostic impact of MLD in AML MRC.
METHODS
A total of 357 patients newly diagnosed as AML at Asan Medical Center from January 2001 to December 2005 were analyzed. They were diagnosed and classified as AML with recurrent genetic abnormalities, AML MRC, and AML not otherwise specified (AML NOS). Prognostic markers including overall survival (OS) and event free survival (EFS) were obtained through retrospective analysis of electronic medical records.
RESULTS
AML MRC patients showed a lower complete remission (CR) rate (44.7% vs. 64.9%, P=0.002) and shorter OS (297 vs. 561 days, P=0.004) and EFS (229 vs. 374 days, P=0.004) than AML NOS patients. Patients with MLD among AML MRC also showed a lower CR rate (37.7%, P=0.001) and shorter OS (351 days, P=0.036) and EFS (242 days, P=0.076) than AML NOS patients. However, among AML MRC patients, there were no differences in OS, EFS and CR between patients with and without MLD.
CONCLUSIONS
AML MRC patients showed a lower CR rate and shorter OS and EFS than AML NOS patients. AML MRC patients with MLD showed similar results and their prognosis was not different from those without MLD. MLD findings among AML MRC could be an independent poor prognostic factor in de novo AML.

Keyword

Prognosis; Multilineage; Dysplasia; AML; Myelodysplasia; Related; Changes

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Cell Lineage
Child
Child, Preschool
Data Interpretation, Statistical
Disease-Free Survival
Female
Humans
Infant
Leukemia, Myeloid, Acute/complications/diagnosis/*mortality
Male
Middle Aged
Myelodysplastic Syndromes/complications/*diagnosis
Prognosis
Retrospective Studies
Survival Analysis

Figure

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  Fig. 1. Comparison of overall survival and event free survival in 357 patients among 3 AML groups according to revised 2008 WHO classification. Abbreviations: RGA, recurrent genetic abnormalities; MRC, myelodysplasia related changes; NOS, not otherwise specified.

• 

  Fig. 2. Fig. 2. Comparison of overall survival and event free survival of AML MRC patients among 3 subgroups. Abbreviation: MLD, multilineage dysplasia.

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  Fig. 3. Comparison of overall survival and event free survival of AML MLD patients compared with other AML. Abbreviation: MLD, multilineage dysplasia.

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