title: Morphologic characteristics of erythroleukemia (acute myeloid leukemia; FAB-M6): a CALGB study.
abstract: We have reviewed the clinical, morphologic, immunophenotypic, and cytogenetic features of 52 patients with erythroleukemia (FAB Cooperative Group; AML-M6) studied by the Cancer and Leukemia Group B (CALGB). The purpose of this study was to correlate morphology with the clinical features, immunophenotypes, and karyotypes of neoplastic cells, and with the response to therapy of patients with AML-M6. Thirty-three patients (63%) were male, median age 59 (range 16-81) years, 47 patients (90%) were white, and 42 patients (81%) had a performance status of < 2. Myelodysplastic changes were observed in at least 1 cell lineage in all cases, and in 2 cell lineages in 45 of 52 (86%) cases. Fifty percent or more of cases studied were positive for CD11b, CD13, CD15, CD33, glycophorin-A, and HLA-DR markers. Fourteen of 27 cases (52%) in whom karyotypic analyses were conducted had cytogenetic abnormalities. Five (19%) were simple (< 3 karyotypic abnormalities), while 9 (33%) were complex (> or = 3 abnormalities). We observed either a complete or partial loss of chromosomes 5, 7, or 12p, or the presence of trisomy 8, in 11 of 27 (41%) patients. Cases of AML-M6 were divided into group 1 (14 patients with bone marrow proerythroblasts and basophilic erythroblasts > 25% of all erythroblasts) and group 2 (38 patients with proerythroblasts and basophilic erythroblasts < or = 25% of all erythroblasts). We observed no significant differences between groups 1 and 2 in regard to sex, age, race, performance status, percentage of blood erythroblasts or myeloblasts, percentage of bone marrow erythroblasts, and periodic acid-Schiff (PAS) or myelodysplasia scores. Six of 6 (100%) patients of group 1, and 7 of 21 (33%) patients of group 2, had normal karyotypes (P = .006). Nine of 13 (69%) patients of group 1 and 15 of 33 (45%) patients of group 2 had a complete remission (CR) (P = .2). Eight of 11 (73%) cytogenetically normal patients achieved CR: 5 of 6 (83%) in group 1, and 3 of 5 (60%) in group 2. Five of 12 (42%) cytogenetically abnormal patients achieved CR. No difference in duration of survival (group 1, median = 4.6 months vs. group 2, median = 10.2 months; P = .93) was observed between the 2 groups. We conclude that AML-M6 is typified by multilineage involvement of hematopoietic cells. The morphology of erythroblasts in patients with AML-M6 may correlate with cytogenetic abnormalities and rate of CR.
authors.affiliation: Department of Pathology, SUNY Health Science Center, Syracuse, NY 13210, USA.
authors.forename: F R
authors.initials: FR
authors.lastname: Davey
authors.forename: N
authors.initials: N
authors.lastname: Abraham
authors.forename: V L
authors.initials: VL
authors.lastname: Brunetto
authors.forename: J M
authors.initials: JM
authors.lastname: MacCallum
authors.forename: D A
authors.initials: DA
authors.lastname: Nelson
authors.forename: E D
authors.initials: ED
authors.lastname: Ball
authors.forename: J D
authors.initials: JD
authors.lastname: Griffin
authors.forename: M R
authors.initials: MR
authors.lastname: Baer
authors.forename: D
authors.initials: D
authors.lastname: Wurster-Hill
authors.forename: R J
authors.initials: RJ
authors.lastname: Mayer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D001853:Bone Marrow / Q000473:pathology; D002869:Chromosome Aberrations; D025063:Chromosome Disorders; D002881:Chromosomes, Human, Pair 12; D002895:Chromosomes, Human, Pair 5; D002897:Chromosomes, Human, Pair 7; D002898:Chromosomes, Human, Pair 8; D003582:Cytogenetics; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007621:Karyotyping; D004915:Leukemia, Erythroblastic, Acute / Q000097:blood* / Q000235:genetics* / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014314:Trisomy
chemical_list: D015703:Antigens, CD; D006684:HLA-DR Antigens