title: Acute megakaryoblastic leukaemia: a national clinical and biological study of 53 adult and childhood cases by the Groupe Français d'Hématologie Cellulaire (GFHC).
abstract: Since the WHO classification of haematological malignancies recommended the description of global entities, we performed a national M7-AML study to correlate morphological, immunological and cytogenetic features, and to find new clinically relevant M7 entities. This study is based on accurate morphological and immunological study to select pure megakaryoblastic proliferations and to eliminate megakaryocytic participation in haemopathies. We collected 53 cases: 23 adults and 30 children. We confirm the wide heterogeneity of adult M7. In adults, the cytogenetic abnormalities are frequently those of secondary leukaemia while a few patients have a previous history and morphological features of dyshaematopoiesis; their outcome is very poor. Among children, besides the well-known Down syndrome M7, we in particular, studied ten t(1;22) M7 and one OTT-MAL transcript positive case with normal karyotype presenting specific features. We were already aware of their younger age, female and tumoral presentation, but we also found a lower percentage of bone marrow blasts, sometimes without any megakaryoblastic bone marrow involvement, but always, with a dysmegakaryocytopoiesis associated with micromegakaryocytes. They are generally good responders to intensive AML chemotherapy with very long disease-free survivals (DFS). Accordingly, OTT-MAL transcript study, in infant M7 with normal karyotype, is recommended and we feel that this entity should be added to the WHO AML classification.
authors.affiliation: Laboratoire d'Hématologie, Hôpital Purpan, 31059 Toulouse-Purpan, France. duchayne.e@chu-toulouse.fr
authors.forename: Eliane
authors.initials: E
authors.lastname: Duchayne
authors.forename: Odile
authors.initials: O
authors.lastname: Fenneteau
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Pages
authors.forename: Danielle
authors.initials: D
authors.lastname: Sainty
authors.forename: Christine
authors.initials: C
authors.lastname: Arnoulet
authors.forename: Nicole
authors.initials: N
authors.lastname: Dastugue
authors.forename: Richard
authors.initials: R
authors.lastname: Garand
authors.forename: Georges
authors.initials: G
authors.lastname: Flandrin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001752:Blast Crisis / Q000235:genetics / Q000473:pathology; D001773:Blood Cells / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D002454:Cell Differentiation; D048429:Cell Size; D002675:Child, Preschool; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D007231:Infant, Newborn; D007947:Leukemia, Megakaryoblastic, Acute / Q000145:classification* / Q000150:complications / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies