title: Characteristics of acute myeloid leukemia with myelodysplasia-related changes: A retrospective analysis in a cohort of Chinese patients.
abstract: We retrospectively analyzed 449 patients with AML under the WHO classification of AML 2008 and probed implications of this classification in diagnosis and treatment of acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) among them. The clinical presentations, biological features, treatments, and prognosis of patients diagnosed with AML-MRC were analyzed and compared with those of AML not otherwise specified (AML-NOS). In all patients, 115 (25.6%) were diagnosed as AML-MRC including 64 males and 51 females with median onset age of 48 years (range from 17 to 78). Their complete remission (CR) rate was 60.9% and relapse rate was 57.1%. The observed median overall survival (OS) and disease-free survival (DFS) were 10 and 5 months, respectively, which was significantly shorter than those of AML-NOS patients (P < 0.05). The prognosis of AML-MRC patients with myelodysplastic syndrome (MDS)-related cytogenetics sole was similar to those with history of MDS or myelodysplastic/myeloproliferative neoplasm (MDS/MPN). Patients with MDS-related cytogenetic abnormalities and/or history of MDS or MDS/MPN predisposed significantly shortened CR, OS, and DFS than AML-MRC patients with only multilineage dysplasia (MLD) and AML-NOS patients (P < 0.05). Multivariate analysis showed that age, cytogenetics, and history of MDS or MDS/MPN were independent prognostic factors. Patient diagnosed as AML-MRC presented distinctive clinical and biological features. Presence of MLD does not change the prognosis.
authors.affiliation: Department of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Xiao-Qian
authors.initials: XQ
authors.lastname: Xu
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.forename: Hui-Ying
authors.initials: HY
authors.lastname: Qiu
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.forename: Lin
authors.initials: L
authors.lastname: Jia
authors.forename: Xiao-Xia
authors.initials: XX
authors.lastname: Hu
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yang
authors.forename: Xiong
authors.initials: X
authors.lastname: Ni
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Shu-Qing
authors.initials: SQ
authors.lastname: Lü
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Zhang
authors.forename: Xian-Min
authors.initials: XM
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D022762:CCAAT-Enhancer-Binding Proteins / Q000235:genetics; D002681:China; D015331:Cohort Studies; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D059785:Karyotype; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D009687:Nuclear Proteins / Q000235:genetics; D000090243:Nucleophosmin; D012189:Retrospective Studies; D055815:Young Adult; D051941:fms-Like Tyrosine Kinase 3 / Q000235:genetics
chemical_list: D022762:CCAAT-Enhancer-Binding Proteins; C515848:CEBPA protein, human; D009687:Nuclear Proteins; D000090243:Nucleophosmin; C497970:FLT3 protein, human; D051941:fms-Like Tyrosine Kinase 3