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Cytogenetic studies and their prognostic significance in agnogenic myeloid
metaplasia: a report on 47 cases
JL Demory, B Dupriez, P Fenaux, JL Lai, R Beuscart, JP Jouet, M Deminatti and F Bauters
Service des Maladies du Sang, Centre Hospitalier Regional, Lille, France.
Cytogenetic analysis was performed in 47 newly diagnosed patients with
agnogenic myeloid metaplasia (AMM); 32 had a normal karyotype (68%, group
I), whereas 15 had clonal abnormalities (32%, group II). The most frequent
abnormal findings were a 20q- deletion in six cases (either alone or within
complex anomalies), interstitial 13q- deletion in three cases (and monosomy
13 in one case), and acquired trisomy 21 or 21p+ in three cases. Four cases
exhibited complex aberrations involving several chromosomes, sometimes with
a mosaicism. In two patients with an initial abnormal karyotype, further
cytogenetic analysis during the disease course showed the appearance of
additional clonal anomalies, and particularly of a probable Philadelphia
(Ph1) variant in one case. Treatment was essentially supportive. Survival
was significantly shorter in group II (median, 30 months) compared with
group I (median, not reached at 6 years; P = .015). In univariate analysis,
other parameters significantly associated with a poor prognosis (P less
than .05) were higher age, anemia, and increased percentage of circulating
blasts. However, in a multivariate analysis, only cytogenetic abnormalities
and age retained their independent prognostic value.
Volume 72,
Issue 3,
pp. 855-859,
09/01/1988
Copyright © 1988 by The American Society of Hematology
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