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Published in: Cancer Cell International 1/2014

Open Access 01-12-2014 | Primary research

Clinical and laboratory features of seven patients with acute myeloid leukemia (AML)-M2/M3 and elevated myeloblasts and abnormal promyelocytes

Authors: GanLin He, ChunYan Wang, QingEn Li, Huo Tan, FuXiong Chen, ZhenQian Huang, BaoDan Yu, LiXia Zheng, RunHui Zheng, Dan Liu

Published in: Cancer Cell International | Issue 1/2014

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Abstract

Background

There is limited information on a special subtype of Acute myeloid leukemia (AML) characterized by >20% myeloblasts and >20% abnormal promyelocytes in bone marrow and peripheral blood.

Objective

The objective of the present investigation was to explore the clinical and laboratory features of seven patients with AML-M2/M3.

Method

We retrospectively assessed cell morphology, cytochemistry, immunophenotype, cytogenetics, and clinical features of seven patients with this rare subtype of AML.

Results

All seven cases had thrombocytopenia, coagulation abnormalities, >20% myeloblasts and abnormal promyelocytes. The PML/RARα fusion gene was present in six patients and two patients presented a mixed PML/RARα and AML1/ETO genotype. Five cases achieved CR and two cases did not achieve remission and one case transform into AML-M2 after CR1.

Conclusions

The clinical and laboratory features of seven patients with AML-M2/M3 are demonstrated in the present study, providing information on the FAB sub-classification.
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Literature
1.
go back to reference Jaffe ES, Harris NL, Stein H, Vardiman JW: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Hematopoietic and Lymphoid Tissues. 2001, IARC, Lyon, France Jaffe ES, Harris NL, Stein H, Vardiman JW: World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Hematopoietic and Lymphoid Tissues. 2001, IARC, Lyon, France
2.
go back to reference Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW: WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues. 2008, IARC, Lyon, France Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW: WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues. 2008, IARC, Lyon, France
3.
go back to reference Estey E, Dohner H: Acute myeloid leukemia. Lancet. 2006, 368 (9550): 1894-1907. 10.1016/S0140-6736(06)69780-8.CrossRefPubMed Estey E, Dohner H: Acute myeloid leukemia. Lancet. 2006, 368 (9550): 1894-1907. 10.1016/S0140-6736(06)69780-8.CrossRefPubMed
4.
go back to reference Lowenberg B, Downing JR, Burnett A: Acute myeloid leukemia. N Engl J Med. 1999, 341 (14): 1051-1062. 10.1056/NEJM199909303411407.CrossRefPubMed Lowenberg B, Downing JR, Burnett A: Acute myeloid leukemia. N Engl J Med. 1999, 341 (14): 1051-1062. 10.1056/NEJM199909303411407.CrossRefPubMed
5.
go back to reference Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, Sultan C: Proposed revised criteria for the classification of acute myeloid leukemia. A report of the French-American-British Cooperative Group. Ann Intern Med. 1985, 103 (4): 620-625. 10.7326/0003-4819-103-4-620.CrossRefPubMed Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, Sultan C: Proposed revised criteria for the classification of acute myeloid leukemia. A report of the French-American-British Cooperative Group. Ann Intern Med. 1985, 103 (4): 620-625. 10.7326/0003-4819-103-4-620.CrossRefPubMed
6.
go back to reference De Jonge HJ, Huls G, de Bont ES: Gene expression profiling in acute myeloid leukemia. Neth J of Med. 2011, 69 (4): 167-176. De Jonge HJ, Huls G, de Bont ES: Gene expression profiling in acute myeloid leukemia. Neth J of Med. 2011, 69 (4): 167-176.
7.
go back to reference Vardiman JW, Harris NL, Brunning RD: The World Health Organization (WHO) classification of the myeloid neoplasms. Blood. 2002, 100 (7): 2292-2302. 10.1182/blood-2002-04-1199.CrossRefPubMed Vardiman JW, Harris NL, Brunning RD: The World Health Organization (WHO) classification of the myeloid neoplasms. Blood. 2002, 100 (7): 2292-2302. 10.1182/blood-2002-04-1199.CrossRefPubMed
8.
go back to reference Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, Harris NL, Le Beau MM, Hellström-Lindberg E, Tefferi A, Bloomfield CD: The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009, 114: 937-951. 10.1182/blood-2009-03-209262.CrossRefPubMed Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, Harris NL, Le Beau MM, Hellström-Lindberg E, Tefferi A, Bloomfield CD: The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009, 114: 937-951. 10.1182/blood-2009-03-209262.CrossRefPubMed
9.
go back to reference Kelly LM, Gilliland DG: Genetics of myeloid leukemia. Annu Rev Genomics Hum Genet. 2002, 3: 179-198. 10.1146/annurev.genom.3.032802.115046.CrossRefPubMed Kelly LM, Gilliland DG: Genetics of myeloid leukemia. Annu Rev Genomics Hum Genet. 2002, 3: 179-198. 10.1146/annurev.genom.3.032802.115046.CrossRefPubMed
10.
go back to reference Stavroyianni N, Kalmantis T, Yataganas X: Simultaneous PML/RAR alpha and AML 1/ETO gene rearrangements in a patient with acute myeloid leukemia. Leukemia. 1999, 13 (08): 294-295. Stavroyianni N, Kalmantis T, Yataganas X: Simultaneous PML/RAR alpha and AML 1/ETO gene rearrangements in a patient with acute myeloid leukemia. Leukemia. 1999, 13 (08): 294-295.
11.
go back to reference Schlenk RF, Dohner K, Krauter J, Fröhling S, Corbacioglu A, Bullinger L, Habdank M, Späth D, Morgan M, Benner A, Schlegelberger B, Heil G, Ganser A, Döhner H: Mutations and treatment outcome in cytogenetically normal acute myeloid leukemia. N Engl J Med. 2008, 358: 1909-1918. 10.1056/NEJMoa074306.CrossRefPubMed Schlenk RF, Dohner K, Krauter J, Fröhling S, Corbacioglu A, Bullinger L, Habdank M, Späth D, Morgan M, Benner A, Schlegelberger B, Heil G, Ganser A, Döhner H: Mutations and treatment outcome in cytogenetically normal acute myeloid leukemia. N Engl J Med. 2008, 358: 1909-1918. 10.1056/NEJMoa074306.CrossRefPubMed
12.
go back to reference Arber DA, Stein AS, Carter NH, Ikle D, Forman SJ, Slovak ML: Prognostic impact of acute myeloid leukemia classification. Importance of detection of recurring cytogenetic abnormalities and multilineage dysplasia on survival. Am J Clin Pathol. 2003, 119: 672-680. 10.1309/EM7KCQR4GLMHRCX4.CrossRefPubMed Arber DA, Stein AS, Carter NH, Ikle D, Forman SJ, Slovak ML: Prognostic impact of acute myeloid leukemia classification. Importance of detection of recurring cytogenetic abnormalities and multilineage dysplasia on survival. Am J Clin Pathol. 2003, 119: 672-680. 10.1309/EM7KCQR4GLMHRCX4.CrossRefPubMed
13.
go back to reference Haferlach T, Schoch C, Loffler H, Gassmann W, Kern W, Schnittger S, Fonatsch C, Ludwig WD, Wuchter C, Schlegelberger B, Staib P, Reichle A, Kubica U, Eimermacher H, Balleisen L, Grüneisen A, Haase D, Aul C, Karow J, Lengfelder E, Wörmann B, Heinecke A, Sauerland MC, Büchner T, Hiddemann W: Morphologic dysplasia in de novo acute myeloid leukemia (AML) is related to unfavorable cytogenetics but has no independent prognostic relevance under the conditions of intensive induction therapy: results of a multiparameter analysis from the German AML Cooperative Group studies. J Clin Oncol. 2003, 21: 256-265. 10.1200/JCO.2003.08.005.CrossRefPubMed Haferlach T, Schoch C, Loffler H, Gassmann W, Kern W, Schnittger S, Fonatsch C, Ludwig WD, Wuchter C, Schlegelberger B, Staib P, Reichle A, Kubica U, Eimermacher H, Balleisen L, Grüneisen A, Haase D, Aul C, Karow J, Lengfelder E, Wörmann B, Heinecke A, Sauerland MC, Büchner T, Hiddemann W: Morphologic dysplasia in de novo acute myeloid leukemia (AML) is related to unfavorable cytogenetics but has no independent prognostic relevance under the conditions of intensive induction therapy: results of a multiparameter analysis from the German AML Cooperative Group studies. J Clin Oncol. 2003, 21: 256-265. 10.1200/JCO.2003.08.005.CrossRefPubMed
14.
go back to reference Pileri SA, Ascani S, Cox MC, Campidelli C, Bacci F, Piccioli M, Piccaluga PP, Agostinelli C, Asioli S, Novero D, Bisceglia M, Ponzoni M, Gentile A, Rinaldi P, Franco V, Vincelli D, Pileri A, Gasbarra R, Falini B, Zinzani PL, Baccarani M: Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia. 2007, 21: 340-350. 10.1038/sj.leu.2404491.CrossRefPubMed Pileri SA, Ascani S, Cox MC, Campidelli C, Bacci F, Piccioli M, Piccaluga PP, Agostinelli C, Asioli S, Novero D, Bisceglia M, Ponzoni M, Gentile A, Rinaldi P, Franco V, Vincelli D, Pileri A, Gasbarra R, Falini B, Zinzani PL, Baccarani M: Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia. 2007, 21: 340-350. 10.1038/sj.leu.2404491.CrossRefPubMed
15.
go back to reference Matutes E, Morilla R, Farahat N, Carbonell F, Swansbury J, Dyer M, Catovsky D: Definition of acute biphenotypic leukemia. Hematological. 1997, 82: 64-66. Matutes E, Morilla R, Farahat N, Carbonell F, Swansbury J, Dyer M, Catovsky D: Definition of acute biphenotypic leukemia. Hematological. 1997, 82: 64-66.
16.
go back to reference Hanson CA, Abaza M, Sheldon S, Ross CW, Schnitzer B, Stoolman LM: Acute biphenotypic leukemia: immunophenotypic and cytogenetic analysis. Br J Haematol. 1993, 84: 49-60. 10.1111/j.1365-2141.1993.tb03024.x.CrossRefPubMed Hanson CA, Abaza M, Sheldon S, Ross CW, Schnitzer B, Stoolman LM: Acute biphenotypic leukemia: immunophenotypic and cytogenetic analysis. Br J Haematol. 1993, 84: 49-60. 10.1111/j.1365-2141.1993.tb03024.x.CrossRefPubMed
17.
go back to reference Sulak LE, Clare CN, Morale BA, Hansen KL, Montiel MM: Biphenotypic acute leukemia in adults. Am J Clin Pathol. 1990, 94: 54-58.PubMed Sulak LE, Clare CN, Morale BA, Hansen KL, Montiel MM: Biphenotypic acute leukemia in adults. Am J Clin Pathol. 1990, 94: 54-58.PubMed
18.
go back to reference Mirabelli P, Scalia G, Pascariello C, D'Alessio F, Mariotti E, Di Noto R, George TC, Kong R, Venkatachalam V, Basiji D, Del Vecchio L: ImageStream promyelocytic leukemia protein immunolocalization: in search of promyelocytic leukemia cells. Cytometry. 2012, 81 (3): 232-237. 10.1002/cyto.a.22013.CrossRefPubMed Mirabelli P, Scalia G, Pascariello C, D'Alessio F, Mariotti E, Di Noto R, George TC, Kong R, Venkatachalam V, Basiji D, Del Vecchio L: ImageStream promyelocytic leukemia protein immunolocalization: in search of promyelocytic leukemia cells. Cytometry. 2012, 81 (3): 232-237. 10.1002/cyto.a.22013.CrossRefPubMed
19.
go back to reference Shen Y, Zhu YM, Fan X, Shi JY, Wang QR, Yan XJ, Gu ZH, Wang YY, Chen B, Jiang CL, Yan H, Chen FF, Chen HM, Chen Z, Jin J, Chen SJ: Gene mutation patterns and their prognostic impact in a cohort of 1185 patients with acute myeloid leukemia. Blood. 2011, 118 (20): 5593-5603. 10.1182/blood-2011-03-343988.CrossRefPubMed Shen Y, Zhu YM, Fan X, Shi JY, Wang QR, Yan XJ, Gu ZH, Wang YY, Chen B, Jiang CL, Yan H, Chen FF, Chen HM, Chen Z, Jin J, Chen SJ: Gene mutation patterns and their prognostic impact in a cohort of 1185 patients with acute myeloid leukemia. Blood. 2011, 118 (20): 5593-5603. 10.1182/blood-2011-03-343988.CrossRefPubMed
20.
go back to reference Desangles F, Vilain E, Arborio M, De Revel T, Flandrin G: t(15;17) hypergranular acute promyelocytic leukemia (M3) developing into a t(3;6) M3 without t(15;17) at relapse. Leuk Lymphoma. 1995, 19: 185-188. 10.3109/10428199509059675.CrossRefPubMed Desangles F, Vilain E, Arborio M, De Revel T, Flandrin G: t(15;17) hypergranular acute promyelocytic leukemia (M3) developing into a t(3;6) M3 without t(15;17) at relapse. Leuk Lymphoma. 1995, 19: 185-188. 10.3109/10428199509059675.CrossRefPubMed
21.
go back to reference Hatzis T, Standen GR, Howell RT, Savill C, Wagstaff M, Scott GL: Acute promyelocytic leukemia (M3): relapse with acute myeloblastic leukemia (M2) and dic(5;17)(q11;p11). Am J Hematol. 1995, 48: 40-44. 10.1002/ajh.2830480108.CrossRefPubMed Hatzis T, Standen GR, Howell RT, Savill C, Wagstaff M, Scott GL: Acute promyelocytic leukemia (M3): relapse with acute myeloblastic leukemia (M2) and dic(5;17)(q11;p11). Am J Hematol. 1995, 48: 40-44. 10.1002/ajh.2830480108.CrossRefPubMed
22.
go back to reference Todisco E, Testi AM, Avvisati G, Moleti ML, Cedrone M, Cimino G, Mancini F, Amadori S, Mandelli F: Therapy-related acute myelomonocytic leukemia following successful treatment for acute promyelocytic leukemia. Leukemia. 1995, 9: 1583-1585.PubMed Todisco E, Testi AM, Avvisati G, Moleti ML, Cedrone M, Cimino G, Mancini F, Amadori S, Mandelli F: Therapy-related acute myelomonocytic leukemia following successful treatment for acute promyelocytic leukemia. Leukemia. 1995, 9: 1583-1585.PubMed
23.
go back to reference Jubashi T, Nagai K, Miyazaki Y, Nakamura H, Matsuo T, Kuriyama K, Tomonaga M: A unique case of acute promyelocytic leukemia (M3) developing into acute myeloblastic leukemia (M1) with t (7; 21) at relapse. Br J Haematol. 1993, 83: 665-668. 10.1111/j.1365-2141.1993.tb04709.x.CrossRefPubMed Jubashi T, Nagai K, Miyazaki Y, Nakamura H, Matsuo T, Kuriyama K, Tomonaga M: A unique case of acute promyelocytic leukemia (M3) developing into acute myeloblastic leukemia (M1) with t (7; 21) at relapse. Br J Haematol. 1993, 83: 665-668. 10.1111/j.1365-2141.1993.tb04709.x.CrossRefPubMed
24.
go back to reference Bonomi R, Giordano H, del Pilar MM, Bodega E, Landoni AI, Gallagher R, del Rosario UM: Simultaneous PML/RARalpha and AML1/ETO expression with t(15;17) at onset and relapse with only t(8;21) in an acute promyelocytic leukemia patient. Cancer Genet Cytogenet. 2000, 123 (1): 41-3. 10.1016/S0165-4608(00)00297-1.CrossRefPubMed Bonomi R, Giordano H, del Pilar MM, Bodega E, Landoni AI, Gallagher R, del Rosario UM: Simultaneous PML/RARalpha and AML1/ETO expression with t(15;17) at onset and relapse with only t(8;21) in an acute promyelocytic leukemia patient. Cancer Genet Cytogenet. 2000, 123 (1): 41-3. 10.1016/S0165-4608(00)00297-1.CrossRefPubMed
25.
go back to reference National Comprehensive Cancer Network Inc. NCCN: Clinical Practice Guidelines in Oncology. Acute Myeloid Leukemia [EB/OL]. [www.nccn.org. 2011; version 2: 1-8] National Comprehensive Cancer Network Inc. NCCN: Clinical Practice Guidelines in Oncology. Acute Myeloid Leukemia [EB/OL]. [www.​nccn.​org. 2011; version 2: 1-8]
26.
go back to reference Nguyen DT, Diamond LW, Braylan RC: Flow cytometry in hematopathology: a visual approach to data analysis and interpretation. Humana Press Inc. 2003, 143–145: 188-191. Nguyen DT, Diamond LW, Braylan RC: Flow cytometry in hematopathology: a visual approach to data analysis and interpretation. Humana Press Inc. 2003, 143–145: 188-191.
27.
go back to reference Béné MC, Porwit A: Acute leukemias of ambiguous lineage. Semin Diagn Pathol. 2012, 29 (1): 12-18. 10.1053/j.semdp.2011.08.004.CrossRefPubMed Béné MC, Porwit A: Acute leukemias of ambiguous lineage. Semin Diagn Pathol. 2012, 29 (1): 12-18. 10.1053/j.semdp.2011.08.004.CrossRefPubMed
28.
go back to reference Lithotripsy. Health and Public Policy Committee, American College of Physicians.Ann Intern Med 1985; 103(4): 626-9., Lithotripsy. Health and Public Policy Committee, American College of Physicians.Ann Intern Med 1985; 103(4): 626-9.,
29.
go back to reference Stanley M: Adult Leukemia 2. Boston. Martinus Nijhoff Publishers. 1985, 29 (1): 147- Stanley M: Adult Leukemia 2. Boston. Martinus Nijhoff Publishers. 1985, 29 (1): 147-
Metadata
Title
Clinical and laboratory features of seven patients with acute myeloid leukemia (AML)-M2/M3 and elevated myeloblasts and abnormal promyelocytes
Authors
GanLin He
ChunYan Wang
QingEn Li
Huo Tan
FuXiong Chen
ZhenQian Huang
BaoDan Yu
LiXia Zheng
RunHui Zheng
Dan Liu
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Cancer Cell International / Issue 1/2014
Electronic ISSN: 1475-2867
DOI
https://doi.org/10.1186/s12935-014-0111-y

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