Azacitidine front-line in 339 patients with myelodysplastic syndromes and acute myeloid leukaemia: comparison of French-American-British and World Health Organization classifications

This study investigated the complete remission (CR) rate and survival of 623 newly diagnosed patients with acute myeloid leukaemia (AML) in Shanghai, China, classified according to World Health Organization and French–American–British criteria, and compared the differences in treatment effect with those reported in developed countries and those reported in Shanghai from 1984 to 1994. Total CR rate was 66.5%, median survival was 18 months and estimated survival at 3 years was 30.8%. The 3-year relapse rate was 55.1%. These data showed that the CR rate was similar to that achieved in studies from developed countries, but long-term survival was worse. The CR rate and survival were increased markedly compared with data previously collected in Shanghai (1984-1994). Induction chemotherapeutic regimens based on idarubicin, daunorubicin or homoharringtonine all had similar CR rates and survivals. Karyotype was the most important prognostic factor. Multilineage dysplasia in de novo AML was not an independent prognostic factor. Improvement in the long-term treatment effect in China is an important challenge for the future.

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Favourable prognostic factors in therapy related acute myeloid leukaemia

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1106347a ◽

2011 ◽

Vol 139 (5-6) ◽

pp. 347-352 ◽

Cited By ~ 2

Author(s):

Nebojsa Antonijevic ◽

Nada Suvajdzic ◽

Tatjana Terzic ◽

Branko Jakovljevic ◽

Gradimir Jankovic ◽

...

Keyword(s):

Prognostic Factors ◽

Acute Myeloid Leukaemia ◽

Myeloid Leukaemia ◽

Radiation Treatment ◽

World Health ◽

Probability Of Survival ◽

Impact On Survival ◽

Cytogenetic Analyses ◽

Health Organization ◽

Acute Myeloid

Introduction. Therapy related acute myeloid leukaemia (t-AML) is a distinct clinical entity recognized by the World Health Organization classification occurring after chemotherapy and/or radiation treatment administered for a previous disease. T-AML is characterised by pancytopenia, three-lineage myelodysplasia, high frequency of unfavourable cytogenetics and short survival. Objective. The aim of this study was to analyse clinical, cytogenetic, and cytological characteristics of t-AML and their impact on survival. Methods. Seventeen patients with t-AML (8 male and 9 female; median age 59 years) were identified among 730 consecutive patients with acute myeloid leukaemia. The degree of three-lineage dysplasia as well as haematological, cytological and cytogenetic analyses, were assessed by standard methods. Results. The patients survived a median of 62.5 days with the 10% probability of survival during two years. Prognostically favourable factors were a higher percentage of dysplastic granulocytic cells, age less than 60 years, and presence of prognostically favourable karyotype inv(16), t(15;17), t(8;21). Conclusion. The stated prognostic factors that include age, cytogenetics findings and granulocytic dysplasia analysis could contribute to adequate risk stratification of t-AML, though fuller results would require additional analyses.

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Comparison of five prognostic scoring systems, the French–American–British (FAB) and World Health Organization (WHO) classifications in patients with myelodysplastic syndromes: results of a single-center analysis

Annals of Hematology ◽

10.1007/s00277-005-0030-z ◽

2006 ◽

Vol 85 (8) ◽

pp. 502-513 ◽

Cited By ~ 29

Author(s):

H. Müller-Berndorff ◽

P. S. Haas ◽

R. Kunzmann ◽

J. Schulte-Mönting ◽

M. Lübbert

Keyword(s):

World Health Organization ◽

Myelodysplastic Syndromes ◽

Scoring Systems ◽

World Health ◽

Single Center ◽

Health Organization ◽

Prognostic Scoring Systems ◽

French American British

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Morphologic classifications of myelodysplastic syndromes: French–American–British (FAB) and World Health Organization (WHO)

Myelodysplastic Syndromes ◽

10.1017/cbo9780511545269.003 ◽

2005 ◽

pp. 33-62

Author(s):

Richard D. Brunning

Keyword(s):

World Health Organization ◽

Myelodysplastic Syndromes ◽

World Health ◽

Health Organization ◽

French American British

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Myelodysplastic syndromes, from French-American-British to World Health Organization: comparison of classifications on 431 unselected patients from a single institution

Blood ◽

10.1182/blood.v98.10.2935 ◽

2001 ◽

Vol 98 (10) ◽

pp. 2935-2941 ◽

Cited By ~ 86

Author(s):

Thomas Nösslinger ◽

Regina Reisner ◽

Elisabeth Koller ◽

Helga Grüner ◽

Heinz Tüchler ◽

...

Keyword(s):

World Health Organization ◽

Myelodysplastic Syndromes ◽

World Health ◽

Single Center ◽

Cell Counts ◽

Starting Point ◽

Significant Difference ◽

Blast Count ◽

Health Organization ◽

French American British

Abstract In 1999 a working group of the World Health Organization (WHO) published a revised classification for myelodysplastic syndromes (MDS): RA, RARS, refractory cytopenia with multilineage dysplasia (RC+Dys), RAEB I and II, del (5q) syndrome, and MDS unclassifiable. Chronic myelomonocytic leukemia (CMML) and RAEB-t were excluded. Standard French-American-British (FAB) and new WHO classifications have been compared in a series of patients (n = 431) from a single center, analyzing morphologic, clinical, and cytogenetic data. According to the WHO findings, dysgranulocytopoiesis or dysmegakaryocytopoiesis only were found in 26% of patients with less than 5% medullary blasts. These patients are thus unclassified and should remain in the subgroups RA and RARS. Splitting of heterogeneous RAEB into 2 subgroups according to blast count was supported by a trend to a statistically significant difference in the single-center study population. Patients with CMML whose white blood cell counts are above 13 000/μL may be excluded from the MDS classification, as warranted by WHO, but a redistribution of patients with dysplastic CMML according to medullary blast count leads to more heterogeneity in other WHO subgroups. Although the natural courses of RAEB-T and acute myeloid leukemia (AML) with dysplasia are different, comparable median survival durations after treatment in patients with RAEB-T and AML were in favor of the proposed 20% medullary blast threshold for AML. The homogeneity of subgroups was studied by evaluating prognostic scores. A significant shift into lower IPSS risk groups was evident in the new classification. These data cannot provide evidence for the new WHO proposal, which should not be adopted for routine clinical use at present. Some of its aspects can provide a starting point for further studies involving refined cytogenetics and clinical results.

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