title: Adult acute megakaryocytic leukemia: an analysis of 37 patients treated at M.D. Anderson Cancer Center.
abstract: To characterize acute megakaryocytic leukemia (FAB M7 AML), we identified 37 patients with M7 AML treated at M.D. Anderson Cancer Center between 1987 and 2003 and compared them with 1800 patients with non-M7, non-M3 AML treated during the same period. The median age of the M7 AML group was 56 years (range, 21-78 years); 22 patients (59%) had an antecedent hematologic disorder or myelodysplastic syndrome or both, and 7 patients (19%) had previously received chemotherapy for other malignancies. Extensive bone marrow fibrosis was found in 23 patients (62%). Poor cytogenetic characteristics were observed in 49% of patients with M7 AML versus 33% of others (P < .001). Complete remission rates were 43% with M7 AML and 57% with non-M7 AML (P = .089). Median overall survival (OS) was 23 and 38 weeks, respectively (P = .006). Median disease-free survivals were 23 versus 52 weeks, respectively (P < .001). By multivariate analysis, M7 AML was an independent adverse prognostic factor for OS, independent of other factors including cytogenetic abnormalities (hazard ratio 1.51, P = .049). These results confirm the poor prognosis of M7 AML and indicate that other biologic characteristics beyond cytogenetic abnormalities likely play a role in this disease.
authors.affiliation: Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oki
authors.forename: Hagop M
authors.initials: HM
authors.lastname: Kantarjian
authors.forename: Xian
authors.initials: X
authors.lastname: Zhou
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Srdan
authors.initials: S
authors.lastname: Verstovsek
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Charles
authors.initials: C
authors.lastname: Koller
authors.forename: Miloslav
authors.initials: M
authors.lastname: Beran
authors.forename: B Nebiyou
authors.initials: BN
authors.lastname: Bekele
authors.forename: Sherry
authors.initials: S
authors.lastname: Pierce
authors.forename: Deborah
authors.initials: D
authors.lastname: Thomas
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
authors.forename: William G
authors.initials: WG
authors.lastname: Wierda
authors.forename: Francis
authors.initials: F
authors.lastname: Giles
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ferrajoli
authors.forename: Elias
authors.initials: E
authors.lastname: Jabbour
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Keating
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Bueso-Ramos
authors.forename: Elihu
authors.initials: E
authors.lastname: Estey
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
mesh_terms: D000328:Adult; D000368:Aged; D002869:Chromosome Aberrations; D002877:Chromosomes, Human; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007947:Leukemia, Megakaryoblastic, Acute / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009369:Neoplasms; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000473:pathology / Q000628:therapy; D055728:Primary Myelofibrosis / Q000401:mortality / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies