Cytogenetic heterogeneity of acute myeloid leukaemia (AML) with trilineage dysplasia: Japan Adult Leukaemia Study Group‐AML 92 study

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<jats:p><jats:bold>Summary.</jats:bold> Acute myeloid leukaemia (AML) with trilineage dysplasia (AML/TLD) is <jats:italic>de novo</jats:italic> AML recognized by the morphological dysplasia of three mature cell lines in the presence of leukaemic blasts. We studied the karyotypes of AML/TLD of patients with <jats:italic>de novo</jats:italic> AML, except for those with the French–American–British classification M3, who were enrolled onto the Japan Adult Leukaemia Study Group (JALSG)‐AML 92 trial. Morphological and cytogenetic analyses were performed in 559 patients and TLD phenotype was found in 155 patients (27·7%). The 511 patients with informative morphological and cytogenetic data were classified into three groups according to karyotype: favourable, intermediate and adverse risk groups (92, 375 and 44 patients respectively). Normal karyotype was the most frequent as a total, and among both the non‐TLD and TLD patients (164 patients 45·3% and 78 patients 52·7% respectively). All but one patient with AML/TLD was classified into the intermediate or adverse cytogenetic risk group. TLD phenotype was associated with lower remission rate and shorter overall survival but it did not influence disease‐free survival. Although we did not find any specific cytogenetic abnormalities for AML/TLD, the rarity of favourable karyotypes among TLD patients indicates the biological difference between AML/TLD and AML/non‐TLD.</jats:p>

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