[Diagnosis and treatment strategy for de novo AML with trilineage myelodysplasia].
The findings of morphologically dysplastic features in hematopoietic cells in de novo AML has been known as AML with trilineage myelodysplasia (AML/TMDS). We analyzed the clinical data and treatment outcomes of 230 de novo AML patients treated with the Japan Adult Leukemia Study Group AML-87 protocol. Forty (17%) patients had AML/TMDS. It was detected in 21% to 34% of patients with M2, M4 and M6, and never seen in patients with M3 and M5. The median age was 48.5 years in the TMDS group and was 48 years in the patients without TMDS, respectively. Platelet count was higher in the TMDS group than that in the TMDS. AML/TMDS was also characterized by fewer blasts in the bone marrow. The complete remission (CR) rate was 63% and 81% in AML patients with and without TMDS, respectively; these rates being significantly different (p = 0.05). The predicted 5-year survival rate of the 40 patients with TMDS was significantly worse than that of the 190 patients without TMDS (9% vs 33%, p = 0.0005). The multivariate analysis revealed that the AML/TMDS was an unfavorable factor in the achievement of CR and in the prediction of longer survival.
Kuriyama
K
K
Department of Hematology, Nagasaki University School of Medicine.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D004912:Erythrocytes / Q000473:pathology; D005260:Female; D006098:Granulocytes / Q000473:pathology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008533:Megakaryocytes / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000473:pathology*; D011379:Prognosis; D012044:Regression Analysis; D012074:Remission Induction