[Clinical and Cytogenetical Characteristics in Acute Myeloid Leukemia with Myelodysplasia-Related Changes]

Abstract

Objective: To explore the clinical and cytogenetic characteristics of acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) based on morphology define.

Methods: A total of 180 newly diagnosed acute myeloid leukemia (AML) patients were enrolled and retrospectively analyzed, and marrow cell morphology of 126 patients were re-evaluated. The clinical and cytogenetic characteristics, including ages, sex, WBC count, HGB level, PLT count, blasts percentage, abnormal karyotype detection rate of the patients in AML with multilineage dysplasia (AML-MRC-1), secondary AML from myelodysplastic/ myeloproliferative neoplasms (MDS/MPN) (AML-MRC-2), and AML not otherwise specified (AML-NOS) groups were investigated.

Results: There was no significant differences between the patients in three groups in terms of sex, age and platelet count (P=0.898, P=0.365, P=0.853), but AML-MRC-2 group (73.2%) was higher than AML-MRC-1 (60.0%) and AML-NOS (56.4%) in the percentages of patients over 60 years old (P=0.228); there were statistically significant differences on WBC count, HGB level, and blasts percentage (P=0.000, P=0.022, P=0.000, AML-MRC-2<AML-MRC-1<AML-NOS). Abnormal karyotypes rate were 59.2% in AML-MRC patients, among which complex karyotypes and myelodysplasia-related cytogenetic abnormalities accounted for 49.3%, and 5q- was the most common (28.2%), followed by 7q-/-7 (19.1%), 17p-/-17 (14.1%), +8 (14.1%), and 20q- (12.7%). Cytogenetic abnormalities rate were compared between the patients in the three groups, the result showed that AML-MRC-2 group (73.2%) was higher than AML-MRC-1 group (40.0%) and AML-NOS group (25.4%) (P=0.000). Complex karyotypes and myelodysplasia-related abnormalities were the main abnormalities in AML-MRC-2 and AML-MRC-1 group, the percentages of complex karyotypes of the patients in the two groups showed statistically significant (41.5% vs 16.7%, P=0.026), while the percentages of other myelodysplasia-related abnormalities showed no statistically significant (17.1% vs 20.0%, P=0.753).

Conclusion: Morphological reassessment of bone marrow cell dysplasia is crucial to the differential diagnoses between AML-MRC (defined only by morphological changes of multilineage dysplasia) and AML-NOS. And the detection rate of cytogenetic abnormalities that mainly consisted of complex karyotypes and myelodysplasia-related abnormalities was higher in AML-MRC patients.