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Myelodysplastic syndrome or acute myeloid leukemia? A study of 28 cases presenting with borderline features
Author(s) -
Scoazec JeanYves,
Imbert Michèle,
Crofts Marilyn,
Jouault Hélène,
Juneja Surender K.,
Vernant JeanPaul,
Sultan Claude
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19850515)55:10<2390::aid-cncr2820551015>3.0.co;2-b
Subject(s) - medicine , myelodysplastic syndromes , myeloid leukemia , refractory anemia , acute leukemia , chemotherapy , presentation (obstetrics) , myeloid , oncology , refractory (planetary science) , leukemia , pediatrics , surgery , bone marrow , physics , astrobiology
Some patients present borderline features between acute myeloid leukemia (AML) and typical myelodysplastic syndromes (MDS): an excess of blasts insufficient to conclusively diagnose AML, yet above the figures usually compatible with MDS or the presence of Auer rods associated with a moderate excess of blasts. This presents considerable difficulties in diagnosis and management. The authors studied 28 such cases using the French‐American‐British Co‐operative Group (FAB) classification, which groups them into a separate category termed “refractory anemia with excess of blasts in transformation” (RAEB‐T). This was found to be a heterogenous group. Certain patients (4/28) had a previously established myelodysplasia, but most presented directly as RAEB‐T. Two very different pictures emerged: a few patients (4/28) were young, with presentation and evolution similar to classic AML, for whom combination chemotherapy was effective; the majority (20/28) were older, with more varied clinical and cytologic presentation, for whom chemotherapy was of little effect and who presented a picture resembling classic RAEB with a median survival of 10 months.