Diagnosis of acute myeloid leukemia according to the WHO classification in the Japan Adult Leukemia Study Group AML-97 protocol.
We reviewed and categorized 638 of 809 patients who were registered in the Japan Adult Leukemia Study Group acute myeloid leukemia (AML)-97 protocol using morphological means. Patients with the M3 subtype were excluded from the study group. According to the WHO classification, 171 patients (26.8%) had AML with recurrent genetic abnormalities, 133 (20.8%) had AML with multilineage dysplasia (MLD), 331 (51.9%) had AML not otherwise categorized, and 3 (0.5%) had acute leukemia of ambiguous lineage. The platelet count was higher and the rate of myeloperoxidase (MPO)-positive blasts was lower in AML with MLD than in the other WHO categories. The outcome was significantly better in patients with high (>or=50%) than with low (<50%) ratios of MPO-positive blasts (P < 0.01). The 5-year survival rates for patients with favorable, intermediate, and adverse karyotypes were 63.4, 39.1, and 0.0%, respectively, and 35.5% for those with 11q23 abnormalities (P < 0.0001). Overall survival (OS) did not significantly differ between nine patients with t(9;11) and 23 with other 11q23 abnormalities (P = 0.22). Our results confirmed that the cytogenetic profile, MLD phenotype, and MPO-positivity of blasts are associated with survival in patients with AML, and showed that each category had the characteristics of the WHO classification such as incidence, clinical features, and OS.
Wakui
Moe
M
Department of Clinical Laboratory Sciences, Hematoimmunology, School of Health Science, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
Kuriyama
Kazutaka
K
Department of Clinical Laboratory Sciences, Hematoimmunology, School of Health Science, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan. kuriyama@med.u-ryukyu.ac.jp.
Miyazaki
Yasushi
Y
Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan.
Hata
Tomoko
T
Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan.
Taniwaki
Masafumi
M
Department of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Ohtake
Shigeki
S
Department of Clinical Laboratory Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Sakamaki
Hisashi
H
Department of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
Miyawaki
Shuichi
S
Department of Hematology, Saiseikai Maebashi Hospital, Maebashi, Japan.
Naoe
Tomoki
T
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Ohno
Ryuzo
R
Aichi Cancer Center, Nagoya, Aichi, Japan.
Tomonaga
Masao
M
Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan.
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000145:classification* / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012042:Registries