ACUTE MYELOMONOCYTIC LEUKEMIA WITH EOSINO PHILIA AND INVERSION OF CHROMOSOME-16 - STUDY OF 6 CASES

The purpose of this study has been to refer the main clinico-biologic characteristics, the evolution and the response to therapy in 6 patien ts with acute myelomonocytic leukemia with eosinophilia and inversion of chromosome 16 (AML4Eo inv[16]) belonging to a series of 92 patients with acute myeloblastic leukemia diagnosed in a single hospital betwe en 1987 and 1995. The main clinical manifestations were anemic syndrom e and hemorrhage, Anemia and thrombocytopenia were present in all case s, high white blood cell count in 4, monocytosis in 5 and eosinophilia in one. Bone marrow aspirate showed myeloid and monocytic blast infil tration (43-62%), eosinophilia (5-19%) and atypical monocytic precurso rs (6-18%). Induction therapy consisted in one or two cycles of daunor ubicin (or idarubicin), cytosine arabinoside and etoposide, followed b y two cycles of consolidation treatment, the first with mitoxanthrone and cytosine arabinoside and the second with amsacrine and cytosine ar abinoside, One patient died in the induction phase, while complete rem ission was obtained in the remaining 5. One patient died during the co nsolidation therapy. Allogeneic bone marrow transplant (BMT) was perfo rmed to one patient and autologous BMT to another, The first patient r emains in complete remission (CR) at 68 months from diagnosis, and the second relapsed 12 months after BMT, Another patient relapsed at 13 m onths from diagnosis and the remaining persists in CR 13 months from d iagnosis. Actuarial probabilities of CR duration and survival were 50% at 5 years. The clinico-biologic characteristics and the response to therapy of patients with AML4Eo inv(16) are similar to those referred in other series. There is a high probability of CR attainment and, pro bably, the relapse rate is lower than that of other subtypes of AML.