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Clinical, morphologic, and cytogenetic characteristics of 26 patients with
acute erythroblastic leukemia
OI Olopade, M Thangavelu, RA Larson, R Mick, A Kowal-Vern, HR Schumacher, MM Le Beau, JW Vardiman and JD Rowley
Department of Medicine, University of Chicago, IL.
We have performed a retrospective analysis of the clinical, morphologic,
and cytogenetic findings in 26 patients diagnosed between January 1969 and
September 1991 with acute erythroblastic leukemia de novo (EL or AML-M6).
Clonal chromosomal abnormalities were found in 20 (77%) patients (95%
confidence interval [CI], 61% to 93%). Loss of all or part of the long arm
(q) of chromosomes 5 and/or 7 was observed in 17 (65%) patients (95% CI,
47% to 83%). In addition, the karyotypes were often complex, with multiple
abnormalities and subclones. Among the remaining nine patients, six had a
normal karyotype and one each had trisomy 8, t(3;3), or t(3;5). The overall
frequency of abnormalities of chromosomes 5 and/or 7 observed in our M6
patients is similar to that observed in our patients with therapy-related
acute myeloid leukemia (t-AML; 99 of 129 patients, 77%), but substantially
higher than that noted in our other patients with AML de novo (French-
American-British [FAB] subtypes M1-M5: 52 of 334 patients, 16%). Our M6
patients with abnormalities of chromosomes 5 and/or 7 were older and had a
shorter median survival (16 v 77 weeks [P = .005]) than did the M6 patients
without these abnormalities. We found no correlation between morphologic
features and either cytogenetic abnormalities or clinical outcome. Of note
was the finding that the percentage of myeloblasts, which may account for
only a small fraction of the total marrow elements when the revised FAB
criteria are applied, had no bearing on prognosis. We conclude that acute
erythroblastic leukemia, when defined by morphologic criteria, consists of
two distinctive subgroups: one group tends to be older, has complex
cytogenetic abnormalities, especially of chromosomes 5 and/or 7, and shares
biologic and clinical features with t-AML; the other group, with simple or
no detectable cytogenetic abnormalities, has a more favorable prognosis
when treated with intensive chemotherapy.
Volume 80,
Issue 11,
pp. 2873-2882,
12/01/1992
Copyright © 1992 by The American Society of Hematology
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