POOR SURVIVAL IN T(8-21)(Q22-Q22)-ASSOCIATED ACUTE MYELOID-LEUKEMIA WITH LEUKOCYTOSIS

Twenty-nine consecutive cases with a t(8;21)(q22;q22) in the bone marr ow (BM) karyotype were retrospectively studied concerning clinical, mo rphological and cytogenetic data. All had been diagnosed as acute myel oid leukaemia (AML), 27 FAB subtype M2 and two M1, comprising 5% of al l cytogenetically analysed AML during 18 yr, Auer rods were the most c onsistent t(8;21)-associated morphological finding and were demonstrat ed in 92% of the reviewed BM specimens, whereas BM eosinophilia was se en in only 24%. The median age was 53 yr, and 30% of the patients were >60 yr old. Twenty-four patients had received induction chemotherapy; 22 of these (91%) entered a complete remission (CR), The median survi val time in treated patients was 18 months. Leukocytosis at diagnosis (greater than or equal to 20x10(9)/1) was significantly (p=0.01) assoc iated with shorter survival time. All four children are still in first CR after 9-80 months, Seven cases (25%) developed granulocytic sarcom as, discovered either at diagnosis (n=4) or at first relapse (n=3). Se condary chromosome abnormalities were found in 62% of the cases, most often loss of a sex chromosome. The presence of such secondary aberrat ions did not correlate with any morphological or clinical characterist ics, including survival. This first Scandinavian study of AML with t(8 ;21) corroborates the previous findings that these AMLs are characteri zed by distinct morphological features, a high frequency of CR and a s triking tendency to develop extramedullary leukaemic manifestations. L eukocytosis at diagnosis indicates a less favourable prognosis.