Clinical characterization of acute myeloid leukemia with myelodysplasia-related changes as defined by the 2008 WHO classification system

Weinberg, Olga K.; Seetharam, Mahesh; Ren, Li; Seo, Katie; Ma, Lisa; Merker, Jason D.; Gotlib, Jason; Zehnder, James L.; Arber, Daniel A.

doi:10.1182/blood-2008-10-182782

Cited by 145 publications

(71 citation statements)

References 20 publications

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“…It still remains controversial whether OS and DFS will be affected by MLD. We can found some other reports [6,[9][10][11][12][13][14][15] supporting that MLD affected the prognosis of AML patients. However, if looking carefully into their results, they did not show that MLD was an independent prognostic factor in patient with AML.…”

Section: Discussionsupporting

confidence: 67%

“…However, in patients with an unfavorable karyotype, dysplasia had no additional prognostic influence. Weinberg et al [12] suggested that AML-MRC (including with a history of MDS/MPN or with MDS-related cytogenetic abnormalities or with MLD rather than MLD-sole) was the independent prognostic factor. In Arber's study [13], AML patients with MLD was combined with therapy-related patients and then compared with AML-NOS patients, by which it was found that the prognosis was better in former group than the latter one.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of acute myeloid leukemia with myelodysplasia‐related changes: A retrospective analysis in a cohort of Chinese patients

Wang

Gao

et al. 2014

American J Hematol

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We retrospectively analyzed 449 patients with AML under the WHO classification of AML 2008 and probed implications of this classification in diagnosis and treatment of acute myeloid leukemia with myelodysplasiarelated changes (AML-MRC) among them. The clinical presentations, biological features, treatments, and prognosis of patients diagnosed with AML-MRC were analyzed and compared with those of AML not otherwise specified (AML-NOS). In all patients, 115 (25.6%) were diagnosed as AML-MRC including 64 males and 51 females with median onset age of 48 years (range from 17 to 78). Their complete remission (CR) rate was 60.9% and relapse rate was 57.1%. The observed median overall survival (OS) and disease-free survival (DFS) were 10 and 5 months, respectively, which was significantly shorter than those of AML-NOS patients (P < 0.05). The prognosis of AML-MRC patients with myelodysplastic syndrome (MDS)-related cytogenetics sole was similar to those with history of MDS or myelodysplastic/myeloproliferative neoplasm (MDS/MPN). Patients with MDS-related cytogenetic abnormalities and/or history of MDS or MDS/MPN predisposed significantly shortened CR, OS, and DFS than AML-MRC patients with only multilineage dysplasia (MLD) and AML-NOS patients (P < 0.05). Multivariate analysis showed that age, cytogenetics, and history of MDS or MDS/MPN were independent prognostic factors. Patient diagnosed as AML-MRC presented distinctive clinical and biological features. Presence of MLD does not change the prognosis.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Characteristics of acute myeloid leukemia with myelodysplasia‐related changes: A retrospective analysis in a cohort of Chinese patients

Wang

Gao

et al. 2014

American J Hematol

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“…In addition, AML with multilineage dysplasia has been associated with a poor prognosis. In our analysis, this variable was not significant by multivariate analysis, probably due to a strong correlation between multilineage dysplasia and older age (26).…”

Section: Discussioncontrasting

confidence: 77%

Characterization and analysis of the outcome of adults with acute myeloid leukemia treated in a Brazilian University hospital over three decades

Filho

Portugal

Loureiro

et al. 2011

Braz J Med Biol Res

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“…In particular, most studies examining 'secondary acute myeloid leukemia' have not differentiated between cases following chronic myelomonocytic leukemia and those following myelodysplastic syndrome, and thus the particular features and prognosis of acute myeloid leukemia following chronic myelomonocytic leukemia are not well described. [12][13][14][15][16] In this retrospective, multi-institutional study, we evaluated the clinicopathologic and genetic features of 38 patients with acute myeloid leukemia arising after a prior diagnosis of chronic myelomonocytic leukemia. We examined the outcome of these patients in comparison with patients with de novo acute myeloid leukemia and acute myeloid leukemia arising from a myelodysplastic syndrome.…”

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confidence: 99%

Clinicopathologic analysis of acute myeloid leukemia arising from chronic myelomonocytic leukemia

Courville

Kourda

et al. 2013

Modern Pathology

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Acute myeloid leukemia arising from chronic myelomonocytic leukemia is currently classified as acute myeloid leukemia with myelodysplasia-related changes, a high-risk subtype. However, the specific features of these cases have not been well described. We studied 38 patients with chronic myelomonocytic leukemia who progressed to acute myeloid leukemia. We compared the clinicopathologic and genetic features of these cases with 180 patients with de novo acute myeloid leukemia and 34 patients with acute myeloid leukemia following myelodysplastic syndromes. We also examined features associated with progression from chronic myelomonocytic leukemia to acute myeloid leukemia by comparing the progressed chronic myelomonocytic leukemia cases with a cohort of chronic myelomonocytic leukemia cases that did not transform to acute myeloid leukemia. Higher white blood cell count, marrow cellularity, karyotype risk score, and Revised International Prognostic Scoring System score were associated with more rapid progression from chronic myelomonocytic leukemia to acute myeloid leukemia. Patients with acute myeloid leukemia ex chronic myelomonocytic leukemia were older (Po0.01) and less likely to receive aggressive treatment (P ¼ 0.02) than de novo acute myeloid leukemia patients. Most cases showed monocytic differentiation and fell into the intermediate acute myeloid leukemia karyotype risk group; 55% had normal karyotype and 17% had NPM1 mutation. Median overall survival was 6 months, which was inferior to de novo acute myeloid leukemia (17 months, P ¼ 0.002) but similar to post myelodysplastic syndrome acute myeloid leukemia. On multivariate analysis of all acute myeloid leukemia patients, only age and karyotype were independent prognostic variables for overall survival. Our findings indicate that acute myeloid leukemia following chronic myelomonocytic leukemia displays aggressive behavior and support placement of these cases within the category of acute myeloid leukemia with myelodysplasia-related changes. The poor prognosis of these patients may be related to an older population and lack of favorable-prognosis karyotypes that characterize many de novo acute myeloid leukemia cases.

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Clinical characterization of acute myeloid leukemia with myelodysplasia-related changes as defined by the 2008 WHO classification system

Cited by 145 publications

References 20 publications

Characteristics of acute myeloid leukemia with myelodysplasia‐related changes: A retrospective analysis in a cohort of Chinese patients

Characteristics of acute myeloid leukemia with myelodysplasia‐related changes: A retrospective analysis in a cohort of Chinese patients

Characterization and analysis of the outcome of adults with acute myeloid leukemia treated in a Brazilian University hospital over three decades

Clinicopathologic analysis of acute myeloid leukemia arising from chronic myelomonocytic leukemia

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