Dyshematopoiesis in de novo acute myeloid leukemia: Cell biological features and prognostic significance (vol 29, pg 523, 1997)

Dyshematopoiesis was found in 44 (42,3%) of 104 cases of de novo acute myel oid leukemia (AML). Dyshematopoietic AML (dys-AML) and AML without hematopo ietic dysplasia (non-dys-AML)were compared with regard to biological, hemat ological, immunophenotypic, and cytogenetic parameters as well as prognosti c criteria. Median age of patients was 55 years in both groups. In dys-AML, the median leukocyte count (p=0.04), peripheral blast (p=0.02) and medulla ry blast cell count (p<0.001) were significantly decreased, whereas the med ian platelet count (p-0.04) was increased. Immunophenotyping demonstrated t hat leukemic blast cells in dys-AML more frequently expressed the adhesion molecules CD54 (p=0.05) and CD58 (p=0.08) than leukemic cells in non-dys-AM L. Cytogenetically. we distinguished two karyotypic patterns, one group wit h a normal karyotype or prognostically favorable single chromosome aberrati ons ("P-0-karyotype"), and another one with unfavorable single aberrations or complex aberrations ("P-1-karyotype"). The incidence of these groups was not significantly different between dys-AML and non-dys-AML. Complete remi ssion rate (CRR) after induction chemotherapy (p=0.03) and overall survival time (OS; p=0.03) were significantly lower in dys-AML. In addition, median disease free survival (DFS; p=n.s.) was inferior compared to non-dys-AML. In the dys-AML as well as in the non-dys-AML patient group, CRR, DFS, and O S were decreased in the P-1- compared to the Pg-subgroup. We conclude that dyshematopoietic AML is characterized by specific cell biological features and that hematopoietic and cytogenetic status represent complementary progn ostic factors in de novo AML.