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Bone marrow dysplasia in patients with newly diagnosed acute myelogenous leukemia does not correlate with history of myelodysplasia or with remission rate and survival
Author(s) -
Ballen Karen K.,
Gary Gilliland D.,
Kalish Leslie A.,
Shulman Lawrence N.
Publication year - 1994
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(19940115)73:2<314::aid-cncr2820730214>3.0.co;2-c
Subject(s) - medicine , bone marrow , dysplasia , myelodysplastic syndromes , pathology , leukemia , gastroenterology , population , chemotherapy , environmental health
Background . The records and initial bone marrow studies of 106 patients with newly diagnosed acute myelogenous leukemia (AML) were analyzed retrospectively to determine whether bone marrow dysplasia was predictive of a previous myelodysplastic disorder or correlated with remission rate and survival. Methods . Bone marrow aspirates and biopsy specimens were reviewed in a blinded fashion; dysplasia was assessed in as objective a manner as possible by numerically scoring nine specific findings: erythrocyte multinuclearity, nuclear fragmentation, megaloblastic characteristics, leukocyte granulation abnormalities and nuclear malformations, Pelger‐Huet cells, and megakaryocytic dysplasia (mononuclear megakaryocytes, micromegakaryocytes, and megakaryocytes with multiple distinct nuclei). Results . Dysplasia of the megakaryocytic line was seen in 34% of patients; 70% of the patients had erythrocyte dysplasia; and 68% had leukocyte dysplasia. Pelger‐Huet cells were seen in bone marrow of 35% of the patients. Overall dysplasia score and specific dysplastic findings such as Pelger‐Huet cells did not correlate with a known history of myelodysplasia ( P = 0.47), cytogenetic abnormalities ( P = 0.35), prior chemotherapy treatment with or without alkylating agents ( P = 1.00), previous malignant disorders such as polycythemia vera ( P = 1.00), remission rate ( P = 0.93), or survival ( P = 0.42). Multivariate analysis confirmed known independent risk factors for remission in this patient population, including age ( P = 0.04), history of prior chemotherapy ( P = 0.04), abnormalities in chromosomes 5, 7, or 8 ( P = 0.02), and type of antileukemia therapy ( P < 0.001). Conclusions . Bone marrow dysplasia is common in patients with AML and does not correlate with a history of myelodysplasia or predict outcome when patients are treated with standard intensive AML therapy.