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Significance of trilineage myelodysplasia in de novo acute myeloid leukaemia during remission rather than at diagnosis
Author(s) -
Tamura Shu,
Takemoto Yoshinobu,
Wada Hiroshi,
Itoh Tohru,
Mori Ako,
Saheki Kaname,
Okada Masaya,
Takatsuka Hiroyuki,
Fujimori Yoshihiro,
Okamoto Takahiro,
Kakishita Eizo
Publication year - 1998
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1998.00766.x
Subject(s) - myeloid leukaemia , medicine , myeloid , complete remission , myelodysplastic syndromes , hematology , immunology , bone marrow , chemotherapy
Patients with trilineage myelodysplasia (TMDS) in de novo acute myeloid leukaemia (AML) at diagnosis and remission were clinically evaluated between 1983 and 1996. AML with TMDS (AML/TMDS) was observed in 20 (12%) of 162 patients with de novo AML at diagnosis. Complete remission (CR) was achieved with combination chemotherapy in 12 (67%) of 18 AML/TMDS cases. This CR rate was relatively worse than the rate of 78% (106/136 cases) of AML without TMDS, but this difference was not significant. Disease‐free survival curves also showed no difference between AML/TMDS and AML without TMDS. During remission, eight (67%) of 12 AML/TMDS cases had myelodysplastic remission marrow (AML/MRM). AML/MRM was also seen in seven (7%) of 106 AML cases without TMDS. The actuarial disease‐free survival was significantly lower in AML/MRM than in AML without MRM ( P = 0.0003). All of the AML/MRM cases exhibited early leukaemic relapse; median remission duration was only 9 months. Clonal changes occurred in two cases of AML/TMDS and five cases of AML/MRM at the time of relapse. These findings suggest that TMDS during remission predicts a poorer prognosis and early leukaemic relapse when compared with the absence of TMDS.