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Biologic Determinants for AML Therapy

  • Conference paper
Acute Leukemias VII

Part of the book series: Haematology and Blood Transfusion / Hämatologie und Bluttransfusion ((HAEMATOLOGY,volume 39))

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Abstract

Cytomorphology as defined by the FAB classification still comprises the backbone of diagnosis of acute leukemias. Cytogenetics and molecular techniques have recently provided new insights into the biology of AML and were found to correlate with morphologic subgroups. Furthermore, the morphologic degree of dysplasia was found to be of prognostic significance although different investigators used different definitions for dysgranulopoiesis (DysG), dyserythropoiesis (DysE), dysmegakaryopoiesis (DysM), and trilineage dysplasia (TLD) and results are controversial.

The clinical significance of cytomorphological aspects and dysplasia was prospectively assessed in the AMLCG-92 trial. Dysplastic features were investigated in 272 patients with newly diagnosed AML. No dysplasia was observed in 34.5% of patients, TLD in 17.6%, all other patients had dysplasia in one or two cell lineages. The overall complete remission (CR) rate in all patients was 73%, no remission (NR) was achieved in 10%, 17% of patients suffered from early death (ED). Patients without any dysplasia achieved CR in 78%, NR in 7%, and ED was 15%. In contrast, TLD patients achieved CR in only 62%, but 23% NR and 15% ED was observed. Median overall survival for patients without any dysplasia was 20 months, but only 10 months for TLD patients (p=0.24). Cytogenetic analyses were available in 66% of patients. Unfavorable karyotypes were observed in 25% of patients with TLD, but in only 6% of patients without any dysplasia (p=0.017). Thus, morphology and cytogenetics provide the means to identify patients with different biology and prognosis in AML and may include informations to adapt treatment strategies accordingly.

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Authors and Affiliations

  1. Dept. of Hematology and Oncology, University of Göttingen, Germany

    T. Haferlach, C. Schoch, D. Haase, B. Wörmann & W. Hiddemann

  2. Second Medical Department, University of Kiel, Kiel, Germany

    H. Löffler & W. Gassmann

  3. Institute of Medical Biology, University of Vienna, Austria

    C. Fonatsch

  4. Institute for Human Genetics, University of Kiel, Kiel, Germany

    B. Schlegelberger

  5. Department for Medical Oncology and Molecular Biology, Robert-Rössle-Hospital, Berlin, Germany

    W.-D. Ludwig

  6. Department of Internal Medicine, University Steglitz, Berlin, Germany

    E. Thiel

  7. Institute for Medical Statistics and Biomathematics, University of Münster, Germany

    A. Heinecke & M. C. Sauerland

  8. Department of Internal Medicine, University of Münster, Münster, Germany

    Th. Büchner

Authors
  1. T. Haferlach
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  2. H. Löffler
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  3. W. Gassmann
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  4. C. Fonatsch
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  5. C. Schoch
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  6. D. Haase
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  7. B. Schlegelberger
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  8. W.-D. Ludwig
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  9. E. Thiel
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  10. A. Heinecke
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  11. M. C. Sauerland
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  12. B. Wörmann
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  13. W. Hiddemann
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  14. Th. Büchner
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Consortia

German AML Cooperative Group

Editor information

Editors and Affiliations

  1. Department of Internal Medicine, University of Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany

    W. Hiddemann  & B. Wörmann  & 

  2. Department of Internal Medicine, USA

    T. Büchner

  3. Department of Pediatrics, University of Münster, Albert-Schweitzer-Straße 33, 48149, Münster, Germany

    J. Ritter  & U. Creutzig  & 

  4. Dept. of Hematology, University of Texas, Anderson Cancer Center, 1515 Holcombe Boulevard, 77030, Houston, Tx., USA

    M. Keating MD PhD  & W. Plunkett MD PhD  & 

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© 1998 Springer-Verlag Berlin Heidelberg

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Haferlach, T. et al. (1998). Biologic Determinants for AML Therapy. In: Hiddemann, W., et al. Acute Leukemias VII. Haematology and Blood Transfusion / Hämatologie und Bluttransfusion, vol 39. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71960-8_9

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  • DOI: https://doi.org/10.1007/978-3-642-71960-8_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-71962-2

  • Online ISBN: 978-3-642-71960-8

  • eBook Packages: Springer Book Archive

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