Acute megakaryoblastic leukaemia (AMKL) in children: a comparison of AMKL with and without Down syndrome.
To characterize childhood acute megakaryoblastic leukaemia (AMKL), we reviewed 45 children with AMKL diagnosed between 1986 and 2005 at Nagoya University Hospital and Japanese Red Cross Nagoya First Hospital. Twenty-four patients (53%) had AMKL associated with Down syndrome (DS-AMKL) and 21 (47%) had non-DS-AMKL. The median age of the DS-AMKL patients was 21 months (range, 8-38 months) and that of non-DS-AMKL patients was 15 months (range, 2-185 months). The morphology of blast cells was categorized into three groups according to the stage of megakaryocyte maturation. The blast cells were more immature in DS-AMKL than in non-DS-AMKL in terms of morphology and immunophenotyping. Cytogenetic abnormalities of leukaemic cells were classified into seven categories: normal karyotype including constitutional trisomy 21 in DS-AMKL; numerical abnormalities only; t(1;22)(p13;q13); 3q21q26 abnormalities; t(16;21)(p11;q22); -5/del(5q) and/or -7/del(7q); and other structural changes. The outcome of children with either DS-AMKL or non-DS-AMKL is excellent. The 10-year overall survival estimate was 79% [95% confidence interval (CI): 54-90] for DS-AMKL and 76% (95% CI: 58-91) for non-DS-AMKL (P = 0.81) with a median follow-up of 78 months (range, 20-243 months). Our study shows the diverse heterogeneity of childhood AMKL and the need for subclassification according to cytogenetic and morphological features.
Hama
Asahito
A
Department of Paediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yagasaki
Hiroshi
H
Takahashi
Yoshiyuki
Y
Nishio
Nobuhiro
N
Muramatsu
Hideki
H
Yoshida
Nao
N
Tanaka
Makito
M
Hidaka
Hirokazu
H
Watanabe
Nobuhiro
N
Yoshimi
Ayami
A
Matsumoto
Kimikazu
K
Kudo
Kazuko
K
Kato
Koji
K
Horibe
Keizo
K
Kojima
Seiji
S
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002675:Child, Preschool; D002869:Chromosome Aberrations; D004314:Down Syndrome / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D005260:Female; D050982:GATA1 Transcription Factor / Q000235:genetics; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D007621:Karyotyping; D007947:Leukemia, Megakaryoblastic, Acute / Q000188:drug therapy / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008297:Male; D009154:Mutation; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
D050982:GATA1 Transcription Factor; C494688:GATA1 protein, human