Chemotherapy for minimally differentiated acute myeloid leukemia (AML-M0)

Yokose, Norio; Ogata, Kíyoyuki; Ito, Toshiharu; Miyake, Keisuke; An, Emi; Inokuchi, Koiti; Yamada, Takashi; Gomi, Seiji; Tanabe, Yasutaka; Ohki, Ichiro; Kuwabara, Tomoko; Hasegawa, S; Shinohara, T; Dan, Kazuo; Nomura, Takeo

doi:10.1007/bf01695886

Cited by 23 publications

(12 citation statements)

References 18 publications

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“…In general, conventional chemotherapy yields disappointing results, especially in adult patients, 6,10,11,18,30 which is also true in adults with AML-M0 in our study that the remission rate was low (25%) and the survival was short (median, 2 months). Though these patients received heterogenous regimen of chemotherapy, all but one (case 16) were treated with cytosine arabinoside and one of anthracyclines, at least, which were similar to the treatment for other subtypes of AML.…”

Section: Discussionmentioning

confidence: 50%

Minimally differentiated acute myeloid leukemia in Taiwan: predominantly occurs in children less than 3 years and adults between 51 and 70 years

et al. 1999

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Acute myeloid leukemia (AML) with minimal differentiation was usually referred to as acute undifferentiated leukemia in the past. With the help of immunophenotyping, this subtype of leukemia was shown to express myeloid antigens on the blasts and was designated AML-M0 by FAB Cooperative Study Group in 1991. Among the 423 consecutive newly diagnosed de novo AML at our institution, 12 (2.8%) were of M0 subtype. The proportion of M0 in AML was higher in children than in adults (8.2% vs 1.7%). Four other M0 patients referred from outside hospitals for immunophenotyping were also included in this study. There were two peaks in age distribution of these 16 patients: less than 3 years and between 51 and 70 years, respectively. Organomegaly was more common in patients with AML-M0 than in those with other subtypes (56.3% vs 29.2%, P = 0.025). The former patients had higher incidences of CD7 and CD34 expression on the leukemic cells than the latter ones (50% vs 16.9%, P = 0.003 and 69.2% vs 37.9%, P = 0.019, respectively). The patients with AML-M0 showed more frequent clonal chromosomal abnormalities in the leukemic cells than other AML patients (83.3% vs 53.9%, P = 0.039); the same is also true for complex cytogenetic aberrations (50% vs 11.4%, P = 0.004). Adults with AML-M0 showed a lower complete remission (CR) rate and significantly poorer survival than those with non M0-AML. However there was no significant difference in outcome between the two groups of pediatric patients. In conclusion, AML-M0 is a unique subtype of leukemia that has distinct age distribution and shows different clinical and biological characteristics from other AML. Adult patients have poor prognosis. Whether pediatric patients had better outcome than adults needs to be clarified in further studies.

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Section: Discussionmentioning

confidence: 50%

Minimally differentiated acute myeloid leukemia in Taiwan: predominantly occurs in children less than 3 years and adults between 51 and 70 years

et al. 1999

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“…Segeren et al [9] reported an incidence of chromosome aberrations in 58% of their cases and, although three samples bore the 7q deletion, no consistent or specific lesions were found. Among six cases of AML-M0, Yokose et al [54] observed one complex karyotype (47,XY, c18/47XY,c18,7q-), while the remainder were normal. Lee et al [3] described the occurrence of chromosome abnormalities in 87% of the samples examined and, in agreement with the observations of Cuneo et al, they found a predominance of complex karyotypes with involvement of chromosome 7 in three cases and chromosome 5 in one case.…”

Section: Cytogeneticsmentioning

confidence: 97%

“…Several groups have tried to investigate the cytogenetic features of AML-M0, with controversial results [3,6,7,9,11,12,[50][51][52][53][54]. Cuneo et al [11] found a higher incidence of abnormal/complex karyotypes and unbalanced chromosome changes (81%) in AML-M0 as compared with a reference sample including AML-M1.…”

Section: Cytogeneticsmentioning

confidence: 99%

Minimally differentiated acute myeloid leukemia (AML-MO): a distinct clinico-biologic entity with poor prognosis

Amadori

Venditti

Poeta

et al. 1996

Annals of Hematology

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FAB proposals for the diagnosis of AML-M0 represent the formal recognition of a distinct entity which has been described over the past few years by several authors and called minimally differentiated acute myeloid leukemia. By definition, AML-M0 includes acute leukemias which do not fit morphological and cytochemical criteria for the diagnosis of AML, and for which myeloid lineage assignment can be made by immunological assay showing positivity for MPO, CD13, and CD33 and negativity for lymphoid markers. Involvement of an early myeloid progenitor in the leukemic process is a possible theory hypothesized to explain the existence of such a form. Validity of this assumption has been based on the observation that AML-M0 frequently bears "stem cell" markers such as CD34, HLA-DR, Tdt, CD7, and promiscuous IgH/TCR gene rearrangements, which are thought to occur in uncommitted cells. Finally, AML-M0 very frequently carries cytogenetic abnormalities common to MDS or secondary AML, such as -5/5q- or -7/7q- deletions and or complex karyotype. In our experience, AML-M0 is also very often associated with the MDR phenotype, which in turn has been found strictly linked to "stem cell" features, especially in MDS. These biological aspects, altogether, translate into a very unfavorable prognosis, confirming even from a clinical point of view that AML-M0 is a distinct entity. In conclusion, "stem cell" markers, MDR phenotype, complex chromosome lesions, frequent occurrence in elderly patients, and intrinsic chemoresistance characterize AML-M0 and indicate the need for tailored treatments, possibly involving the use of MDR modulators and/or differentiating agents.

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“…In fact, acute leukemias sharing identical immunophenotypic patterns can be differently classified (eg biphenotypic leukemias included in the AML-M0 subtype or the opposite) depending on the studies. 19,20,21 In order to overcome this problem, strict criteria to diagnose biphenotypic leukemias have been proposed. 22 None of our cases can be considered as a biphenotypic leukemia according to the latter criteria.…”

Section: Discussionmentioning

confidence: 99%

Acute myeloblastic leukemia with minimal myeloid differentiation: phenotypical and ultrastructural characteristics

Villamor

Rozman

et al. 1998

Leukemia

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AML-M0 is an infrequent form of acute myeloblastic leukemia characterized by negative reaction with myeloperoxidase (MPO), Sudan Black and lymphoid antigens and positivity for CD13 or CD33. In the present study we describe the immunophenotypical and ultrastructural characteristics of a group of AML-M0 in adult patients. Nine out 218 AML leukemias (4.1%) fulfilled the AML-M0 criteria. CD13 or CD33 were positive in eight out nine cases, with two or more positive myeloid antigens being present in 82% of the cases. Immunological MPO was positive in 57% of the cases and CD68 in 33%. In no case were megakaryocytic and erythroid markers present. Four cases (44%) expressed CD7 and TdT but only two coexpressed both antigens. In none of the cases was CD3 or CD22 cytoplasmic expression found. Ultrastructurally, a low number of granules was seen in all cases whereas ferritin particles or rhopheocytosis were not observed. Ultrastructural MPO was positive in one out of five cases and platelet peroxidase (PPO) was negative in the four cases studied. Two out of six cases showed karyotypic abnormalities (hypotetraploidy and a complex karyotype, respectively). In two out three cases a rearranged pattern for J H gene was observed. TCR (C␤ and J␥) rearrangements were not detected in any case. AML-M0 is an infrequent form of acute myeloblastic leukemia. A large panel of myeloid monoclonal antibodies (MoAb) and the study of the cytoplasmic expression of myeloid antigens is necessary to diagnose this form of leukemia. AML-M0 usually coexpress lymphoid markers. Ultrastructural studies may be of help to discard an immature erythroid proliferation.

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Chemotherapy for minimally differentiated acute myeloid leukemia (AML-M0)

Cited by 23 publications

References 18 publications

Minimally differentiated acute myeloid leukemia in Taiwan: predominantly occurs in children less than 3 years and adults between 51 and 70 years

Minimally differentiated acute myeloid leukemia in Taiwan: predominantly occurs in children less than 3 years and adults between 51 and 70 years

Minimally differentiated acute myeloid leukemia (AML-MO): a distinct clinico-biologic entity with poor prognosis

Acute myeloblastic leukemia with minimal myeloid differentiation: phenotypical and ultrastructural characteristics

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