Prognostic value of dysmyelopoietic features in de novo acute myeloid leukaemia: a report on 132 patients.

The prognostic value of cytological features was assessed in 132 patients with de novo acute myeloid leukaemia (AML) treated by anthracycline-cytosine-arabinoside combination chemotherapy. Of these patients, 98 (75%) achieved complete remission (CR). A significantly lower CR rate was seen in patients with trilineage dysmyelopoiesis (TDMP) (P = 0.003), but not in patients with dyserythropoiesis and/or dysgranulopoiesis without abnormal megakaryocytes. Other unfavourable factors were age greater than 50 years (P = 0.042), leucocyte count greater than 100 x 10(9)/l (P = 0.006), M5 FAB subtype (P = 0.013), presence of complex cytogenetic rearrangement or abnormalities of chromosome 5 and/or 7 (P = 0.001). Bone marrow eosinophilia greater than 3% was significantly associated with a higher CR rate (P = 0.04). In a multivariate analysis, a low CR rate was best predicted by the presence of a complex karyotype or abnormalities of chromosome 5 and/or 7 (P = 0.0001) and by the TDMP (P = 0.0036). Median actuarial disease-free survival (DFS) was 24 months. Actuarial DFS was significantly shorter in patients with TDMP (P = 0.0001) and an elevated leucocyte count (P = 0.02). Age, FAB subtype and karyotype had no significant incidence on DFS. Presence of TDMP appears to be an important prognostic factor in de novo AML. This could be used as one of the guidelines to therapy.

[1]  R. Beuscart,et al.  Cytogenetics and their prognostic value in de novo acute myeloid leukaemia: a report on 283 cases , 1989, British journal of haematology.

[2]  Edward J. Lee,et al.  Prognostic impact of cytogenetic abnormalities in patients with de novo acute nonlymphocytic leukemia. , 1989, Blood.

[3]  R. Larson,et al.  Specific chromosomal abnormalities in acute nonlymphocytic leukemia correlate with drug susceptibility in vivo. , 1988, Leukemia.

[4]  M. Tomonaga,et al.  Dysmegakaryocytopoiesis in acute leukaemias: its predominance in myelomonocytic (M4) leukaemia and implication for poor response to chemotherapy , 1987, British journal of haematology.

[5]  D. Catovsky,et al.  Clinical and laboratory features of de novo acute myeloid leukaemia with trilineage myelodysplasia , 1987, British journal of haematology.

[6]  F. Hecht,et al.  Cytogenetic analyses in 89 patients with secondary hematologic disorders--results of a cooperative study. , 1987, Cancer genetics and cytogenetics.

[7]  D. Swirsky,et al.  Features affecting outcome during remission induction of acute myeloid leukaemia in 619 adult patients , 1986, British journal of haematology.

[8]  J. Rowley,et al.  Prognostic implications of morphology and karyotype in primary myelodysplastic syndromes , 1986 .

[9]  J. Rowley,et al.  Rearrangements of chromosome 3 involving bands 3q21 and 3q26 are associated with normal or elevated platelet counts in acute nonlymphocytic leukemia , 1985 .

[10]  G Flandrin,et al.  Proposed revised criteria for the classification of acute myeloid leukemia. A report of the French-American-British Cooperative Group. , 1985, Annals of internal medicine.

[11]  J. Bennett,et al.  Modifications in the classification of primary myelodysplastic syndromes: The addition of a scoring system , 1985, Hematological oncology.

[12]  S. Schrier,et al.  Multivariate analysis of factors associated with outcome of treatment for adults with acute myelogenous leukemia , 1984, Cancer.

[13]  R. Zittoun,et al.  Prognostic value of cytologic parameters in acute myelogenous leukemia , 1984, Cancer.

[14]  D. Swirsky,et al.  8;21 translocation in acute granulocytic leukaemia: cytological, cytochemical and clinical features , 1984, British journal of haematology.

[15]  R. Larson,et al.  Association of an inversion of chromosome 16 with abnormal marrow eosinophils in acute myelomonocytic leukemia. A unique cytogenetic-clinicopathological association. , 1983, The New England journal of medicine.

[16]  B. Mendelow,et al.  Chromosome 3 abnormalities in acute nonlymphocytic leukemia (ANLL) with abnormal thrombopoiesis: report of three patients with a new inversion anomaly and a further case of homologous translocation , 1982 .

[17]  E. Gehan,et al.  A prognostic factor analysis for use in development of predictive models for response in adult acute leukemia , 1982, Cancer.

[18]  H. Gralnick,et al.  Proposals for the classification of the myelodysplastic syndromes , 1982, British journal of haematology.

[19]  C. Bloomfield,et al.  Clinical significance of chromosomal abnormalities in acute lymphoblastic leukemia. , 1984, Cancer genetics and cytogenetics.

[20]  J. Rowley,et al.  Nonrandom chromosome abnormalities in acute leukemia and dysmyelopoietic syndromes in patients with previously treated malignant disease. , 1981, Blood.

[21]  H. Thaler,et al.  Morphological Classification, Response to Therapy, and Survival in 263 Adult Patients With Acute Nonlymphoblastic Leukemia , 1980 .

[22]  Iscn.  International System for Human Cytogenetic Nomenclature , 1978 .

[23]  H. Gralnick,et al.  Proposals for the Classification of the Acute Leukaemias French‐American‐British (FAB) Co‐operative Group , 1976, British journal of haematology.

[24]  M. Seabright.  A rapid banding technique for human chromosomes. , 1971, Lancet.

[25]  B Dutrillaux,et al.  Sur une nouvelle technique d'analyse du caryotype humain. , 1971 .