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Haematologica Feb 2012The hypocellular variant of acute myeloid leukemia accounts for less than 10% of all cases of adult acute myeloid leukemia. It is defined by having less than 20 percent... (Comparative Study)
Comparative Study
BACKGROUND
The hypocellular variant of acute myeloid leukemia accounts for less than 10% of all cases of adult acute myeloid leukemia. It is defined by having less than 20 percent of cellular bone marrow in a biopsy at presentation. It is unclear in the literature whether the outcome of hypocellular acute myeloid leukemia differs from that of non-hypocellular acute myeloid leukemia.
DESIGN AND METHODS
We retrospectively analyzed all the cases reported to be hypocellular acute myeloid leukemia between 2000 and 2009. A second pathology review was conducted and the diagnosis was confirmed in all cases.
RESULTS
One hundred twenty-three (9%) patients were identified: patients with hypocellular acute myeloid leukemia were older than those with non-hypocellular acute myeloid leukemia (P=0.009) and more frequently presented with cytopenias (P<0.001). Forty-one patients with hypocellular acute myeloid leukemia had an antecedent hematologic disorder and 11 patients had received prior chemo-radiotherapy for non-hematopoietic neoplasms. On multivariate analysis, overall survival, remission duration and event-free survival were comparable to those of other patients with acute myeloid leukemia.
CONCLUSIONS
The outcome of hypocellular acute myeloid leukemia does not differ from that of non-hypocellular acute myeloid leukemia.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Retrospective Studies; Survival Rate; Treatment Outcome; Young Adult
PubMed: 22058194
DOI: 10.3324/haematol.2011.046672 -
Archives of Pathology & Laboratory... Oct 2010Rapid advances in understanding the molecular biology of acute myeloid leukemia are transforming the approach to diagnosis, prognostication, and treatment of these cases. (Review)
Review
CONTEXT
Rapid advances in understanding the molecular biology of acute myeloid leukemia are transforming the approach to diagnosis, prognostication, and treatment of these cases.
OBJECTIVE
To briefly review the current state of AML classification with a particular emphasis on the role of molecular studies and their impact on the management of acute myeloid leukemia and other malignancies.
DATA SOURCES
Current literature and experience of the authors.
CONCLUSIONS
While morphology, immunophenotyping, cytogenetics, and clinical history continue to play an important role, an increasing number of molecular tests are now required to properly classify these cases.
Topics: Algorithms; CCAAT-Enhancer-Binding Proteins; Chromosome Aberrations; Chromosomes, Human; DNA Transposable Elements; Gene Deletion; Hematologic Neoplasms; Humans; Karyotyping; Leukemia, Myeloid, Acute; Mutation; Nuclear Proteins; Nucleophosmin; Prognosis; Risk Assessment; Sequence Deletion; World Health Organization
PubMed: 20923295
DOI: 10.5858/2010-0245-RA.1 -
Annals of Laboratory Medicine Sep 2022
Topics: Decitabine; High-Throughput Nucleotide Sequencing; Humans; Leukemia, Myeloid, Acute; Mutation; Sarcoma, Myeloid
PubMed: 35470279
DOI: 10.3343/alm.2022.42.5.602 -
Journal of Pain and Symptom Management Apr 2015
Topics: Attitude to Death; Female; Humans; Leukemia, Myeloid, Acute; Male; Spouses
PubMed: 25701053
DOI: 10.1016/j.jpainsymman.2015.02.002 -
Blood May 2007The transcription factor PAX5 is a critical regulator of B-cell commitment and development. Although normally not expressed in myeloid progenitors, PAX5 has recently...
The transcription factor PAX5 is a critical regulator of B-cell commitment and development. Although normally not expressed in myeloid progenitors, PAX5 has recently been shown to be frequently expressed in myeloid malignancies and to suppress expression of myeloid differentiation genes, compatible with an effect on the differentiation or maintenance of myeloid progenitors. However, previous studies in which PAX5 was ectopically expressed in normal myeloid progenitors in vivo and in vitro provided conflicting results as to the effect of PAX5 on myeloid development. Herein, we demonstrate that on ectopic expression of PAX5 in bone marrow multipotent stem/progenitor cells, cells with a biphenotypic B220(+)GR-1/MAC-1(+) phenotype are produced. These remain cytokine-dependent, but unlike control-transduced cells they sustain long-term generation of myeloid progenitors in vitro and remain capable of myeloid differentiation. Notably, PAX5(+)B220(+)GR-1/MAC-1(+) myeloid progenitors coexpress, at the single-cell level, myeloid genes and otherwise B-cell-specific PAX5 target genes. These findings establish that ectopic expression of PAX5 introduces extensive self-renewal properties in otherwise short-lived myeloid progenitors. Along with the established ectopic expression of PAX5 in acute myeloid leukemia, this motivates a careful investigation of the potential involvement of ectopic PAX5 expression in myeloid and biphenotypic leukemias.
Topics: Animals; B-Lymphocytes; Cell Differentiation; Gene Expression; Humans; Leukemia, Myeloid, Acute; Leukocyte Common Antigens; Macrophage-1 Antigen; Mice; Mice, Knockout; Myeloid Progenitor Cells; Organ Specificity; PAX5 Transcription Factor; Rats; Receptors, Chemokine
PubMed: 17218387
DOI: 10.1182/blood-2006-05-026021 -
Ear, Nose, & Throat Journal Sep 2016Myeloid sarcoma is a rare extramedullary tumor composed of malignant myeloid cells that occur in the presence of myeloid leukemia. We report a case series of pediatric...
Myeloid sarcoma is a rare extramedullary tumor composed of malignant myeloid cells that occur in the presence of myeloid leukemia. We report a case series of pediatric head and neck myeloid sarcomas representative of the epidemiology, symptomatology, laboratorial correlations, prognoses, and treatment of extramedullary leukemia. Presented are 3 cases involving patients ranging from 17 months to 11 years of age. Two patients were successfully treated with chemotherapy, and in the third patient, a large lytic lesion was treated palliatively with proton beam therapy. Knowledge and recognition of myeloid sarcomas is important as they can be locally invasive, and they may also be used as a diagnostic tool or a prognostic indicator for leukemia.
Topics: Child; Child, Preschool; Fatal Outcome; Female; Head and Neck Neoplasms; Humans; Infant; Leukemia, Myeloid; Male; Sarcoma, Myeloid
PubMed: 27657319
DOI: 10.1177/014556131609500902 -
Neurology India 2023
Topics: Humans; Sarcoma, Myeloid; Leukemia, Myeloid, Acute; Hematoma; Leukemia
PubMed: 37635551
DOI: 10.4103/0028-3886.383815 -
Internal Medicine (Tokyo, Japan) Jan 2022
Topics: Capsule Endoscopy; Endoscopy, Gastrointestinal; Gastrointestinal Hemorrhage; Humans; Intestinal Diseases; Sarcoma, Myeloid
PubMed: 34219112
DOI: 10.2169/internalmedicine.7799-21 -
Modern Pathology : An Official Journal... Jun 2013Acute myeloid leukemia arising from chronic myelomonocytic leukemia is currently classified as acute myeloid leukemia with myelodysplasia-related changes, a high-risk... (Comparative Study)
Comparative Study
Acute myeloid leukemia arising from chronic myelomonocytic leukemia is currently classified as acute myeloid leukemia with myelodysplasia-related changes, a high-risk subtype. However, the specific features of these cases have not been well described. We studied 38 patients with chronic myelomonocytic leukemia who progressed to acute myeloid leukemia. We compared the clinicopathologic and genetic features of these cases with 180 patients with de novo acute myeloid leukemia and 34 patients with acute myeloid leukemia following myelodysplastic syndromes. We also examined features associated with progression from chronic myelomonocytic leukemia to acute myeloid leukemia by comparing the progressed chronic myelomonocytic leukemia cases with a cohort of chronic myelomonocytic leukemia cases that did not transform to acute myeloid leukemia. Higher white blood cell count, marrow cellularity, karyotype risk score, and Revised International Prognostic Scoring System score were associated with more rapid progression from chronic myelomonocytic leukemia to acute myeloid leukemia. Patients with acute myeloid leukemia ex chronic myelomonocytic leukemia were older (P<0.01) and less likely to receive aggressive treatment (P=0.02) than de novo acute myeloid leukemia patients. Most cases showed monocytic differentiation and fell into the intermediate acute myeloid leukemia karyotype risk group; 55% had normal karyotype and 17% had NPM1 mutation. Median overall survival was 6 months, which was inferior to de novo acute myeloid leukemia (17 months, P=0.002) but similar to post myelodysplastic syndrome acute myeloid leukemia. On multivariate analysis of all acute myeloid leukemia patients, only age and karyotype were independent prognostic variables for overall survival. Our findings indicate that acute myeloid leukemia following chronic myelomonocytic leukemia displays aggressive behavior and support placement of these cases within the category of acute myeloid leukemia with myelodysplasia-related changes. The poor prognosis of these patients may be related to an older population and lack of favorable-prognosis karyotypes that characterize many de novo acute myeloid leukemia cases.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Bone Marrow; Bone Marrow Examination; Cell Differentiation; Chi-Square Distribution; DNA Mutational Analysis; Disease Progression; Female; Humans; Kaplan-Meier Estimate; Karyotyping; Leukemia, Myeloid, Acute; Leukemia, Myelomonocytic, Chronic; Leukocyte Count; Male; Middle Aged; Monocytes; Multivariate Analysis; Mutation; Myelodysplastic Syndromes; Nuclear Proteins; Nucleophosmin; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk Factors; Switzerland; United States; fms-Like Tyrosine Kinase 3
PubMed: 23307061
DOI: 10.1038/modpathol.2012.218 -
Hematology. American Society of... Dec 2017In recent years, the composite molecular architecture in acute myeloid leukemia (AML) has been mapped out. We now have a clearer understanding of the key genetic... (Review)
Review
In recent years, the composite molecular architecture in acute myeloid leukemia (AML) has been mapped out. We now have a clearer understanding of the key genetic determinants, the major genetic interactions, and the broad order in which these mutations occur. The next impending challenge is to discern how these recent genomic discoveries define disease biology as well as how to use molecular markers to deliver patient-tailored clinical decision support.
Topics: Biomarkers, Tumor; Chromosome Aberrations; Humans; Leukemia, Myeloid, Acute; Precision Medicine; Risk Assessment
PubMed: 29222235
DOI: 10.1182/asheducation-2017.1.37