The percentage of myeloperoxidase-positive blast cells is a strong independent prognostic factor in acute myeloid leukemia, even in the patients with normal karyotype.
To examine whether the percentage of myeloperoxidase (MPO)-positive blast cells is useful as a prognostic factor for acute myeloid leukemia (AML), cytochemical analysis of MPO was performed in 491 patients who were registered to the Japan Adult Leukemia Study Group-AML92 study. Patients were divided into two using the percentage of MPO-positive blast (high [>or=50%] and low (<50%)). Complete remission rates were 85.4% in the former and 64.1% in the latter (P=0.001). The overall survival (OS) and the disease-free survival (DFS) were significantly better in the high MPO group (48.3 vs 18.7% for OS, and 36.3 vs 20.1% for DFS, P<0.001, respectively). Multivariate analysis showed that both karyotype and the percentage of MPO-positive blast cells were equally important prognostic factors. The high MPO group still showed a better survival even when restricted to the intermediate chromosomal risk group or the patients with normal karyotype (P<0.001). The OS of patients with normal karyotype in the high MPO group was almost equal with that of the favorable chromosomal risk group. The percentage of MPO-positive blast cells is a simple and highly significant prognostic factor for AML patients, and especially useful to stratify patients with normal karyotype.
Matsuo
T
T
Blood Transfusion Service, Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Sakamoto Nagasaki, Japan.
Kuriyama
K
K
Miyazaki
Y
Y
Yoshida
S
S
Tomonaga
M
M
Emi
N
N
Kobayashi
T
T
Miyawaki
S
S
Matsushima
T
T
Shinagawa
K
K
Honda
S
S
Ohno
R
R
D000208:Acute Disease; D001752:Blast Crisis / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D004796:Clinical Enzyme Tests; D005260:Female; D006801:Humans; D007621:Karyotyping; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009195:Peroxidase / Q000032:analysis*; D011379:Prognosis; D012074:Remission Induction; D016019:Survival Analysis
D009195:Peroxidase