Acute Myeloid Leukemia with Multilineage Dysplasia in Children

Abstract

We retrospectively surveyed pediatric acute myeloid leukemia (AML) patients with multilineage dysplasia treated with the AML 99 and the Children's Cancer and Leukemia Study Group (CCLSG) AML 9805 protocols. We found only 9 AML patients (2.6%) with multilineage dysplasia among the 341 patients with newly diagnosed de novo AML. Eight of the 9 patients obtained complete remission (CR) following the intensive AML-oriented treatments. Three of 7 patients who underwent stem cell transplantation were alive in CR for more than 4 years, and the 2 patients treated only with chemotherapy were alive in CR for more than 30 months. We did not identify any particular chromosomal abnormalities or differentiation according to the French-American-British classification in these 9 patients. No reports have described AML with multilineage dysplasia in children, and the incidence of the disease is expected to be very low. We plan to conduct a prospective pathologic review to select cases with this disease entity in the next Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG) AML-05 protocol.

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References

  1. 1.

    Brito-Babapulle F, Catovsky D, Galton DA. Clinical and laboratory features of de novo acute myeloid leukemia with trilineage myelodysplasia.Br J Haematol. 1987;66:445–450.

    Article  PubMed  CAS  Google Scholar 

  2. 2.

    Gahn B, Haase D, Unterhalt M, et al. De novo AML with dysplastic hematopoiesis: cytogenetic and prognostic significance.Leukemia. 1996;10:946–951.

    PubMed  CAS  Google Scholar 

  3. 3.

    Goasguen JE, Matsuo T, Cox C, Bennett JM. Evaluation of the dysmyelopoiesis in 336 patients with de novo acute myeloid leukemia: major importance of dysgranulopoiesis for remission and survival.Leukemia. 1992;6:520–525.

    PubMed  CAS  Google Scholar 

  4. 4.

    Kuriyama K, Tomonaga M, Matsuo T, et al. Poor response to intensive chemotherapy in de novo acute myeloid leukemia with trilineage myelodysplasia. Japan Adult Leukaemia Study Group (JALSG).Br J Haematol. 1994;86:767–773.

    Article  PubMed  CAS  Google Scholar 

  5. 5.

    Miyazaki Y, Kuriyama K, Miyawaki S, et al, Japan Adult Leukaemia Study Group. Cytogenetic heterogeneity of acute myeloid leukemia (AML) with trilineage dysplasia: Japan Adult Leukaemia Study Group-AML 92 study.Br J Haematol. 2003;120:56–62.

    Article  PubMed  Google Scholar 

  6. 6.

    Taguchi J, Miyazaki Y, Yoshida S,et al. Allogeneic bone marrow transplantation improves the outcome of de novo AML with trilineage dysplasia (AML-TLD).Leukemia. 2000;14:1861–1866.

    Article  PubMed  CAS  Google Scholar 

  7. 7.

    Sasaki H, Manabe A, Kojima S, et al. Myelodysplastic syndrome in childhood: a retrospective study of 189 patients in Japan.Leukemia. 2001;15:1713–1720.

    Article  PubMed  CAS  Google Scholar 

  8. 8.

    Tsukimoto I, Tawa A, Hanada R, et al. Excellent outcome of risk stratified treatment for childhood acute myeloid leukemia-AML 99 trial: for the Japanese Childhood AML Cooperative Study Group.Blood. 2005;106:261a. Abstract 889.

    Google Scholar 

  9. 9.

    Grimwade D, Walker H, Oliver F, et al. The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children’s Leukaemia Working Parties.Blood. 1998;92:2322–2333.

    CAS  Google Scholar 

  10. 10.

    Brunning RD, Matutes E, Harris NL, et al. Acute myeloid leukemia with multilineage dysplasia. In: Jaffe ES, Harris NL, Stein H, Vardiman JW, eds.World Health Organization Classification of Tumours. Pathology & Genetics: Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2001.

    Google Scholar 

  11. 11.

    Estienne MH, Fenaux P, Preudhomme C, et al. Prognostic value of dysmyelopoietic features in de novo acute myeloid leukemia: a report on 132 patients.Clin Lab Haematol. 1990;12:57–65.

    Article  PubMed  CAS  Google Scholar 

  12. 12.

    Ballen KK, Gilliland DG, Kalish LA, Shulman LN. Bone marrow dysplasia in patients with newly diagnosed acute myelogenous leukemia does not correlate with history of myelodysplasia or with remission rate and survival.Cancer. 1994;73:314–321.

    Article  PubMed  CAS  Google Scholar 

  13. 13.

    Meckenstock G, Aul C, Hildebrandt B, et al. Dyshematopoiesis in de novo acute myeloid leukemia: cell biological features and prognostic significance.Leuk Lymphoma. 1998;29:523–531.

    Article  PubMed  CAS  Google Scholar 

  14. 14.

    Kahl C, Florschütz A, Müller G, et al. Prognostic significance of dysplastic features of hematopoiesis in patients with de novo acute myelogenous leukemia.Ann Hematol. 1997;75:91–94.

    Article  PubMed  CAS  Google Scholar 

  15. 15.

    Kuriyama K, Tomonaga M, Kobayashi T, et al. Morphological diagnosis of the Japan Adult Leukemia Study Group acute myeloid leukemia protocols: central review.Int J Hematol. 2001;73:93–99.

    Article  PubMed  CAS  Google Scholar 

  16. 16.

    Haferlach T, Schoch C, Löffer H, et al. 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.

    Article  PubMed  Google Scholar 

  17. 17.

    Tomizawa D, Tabuchi K, Kinoshita A, et al. Repetitive cycles of high-dose cytarabine are effective for childhood acute myeloid leukemia: long-term outcome of the children with AML treated on two consecutive trials of Tokyo Children’s Cancer Study Group.Pediatr Blood Cancer. 2007;49:127–132.

    Article  PubMed  Google Scholar 

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Correspondence to Souichi Adachi or Atsushi Manabe or Masue Imaizumi or Takashi Taga or Akio Tawa or Masahito Tsurusawa or Akira Kikuchi or Atsuko Masunaga or Masahiro Tsuchida or Tatsutoshi Nakahata.

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Adachi, S., Manabe, A., Imaizumi, M. et al. Acute Myeloid Leukemia with Multilineage Dysplasia in Children. Int J Hematol 86, 358–363 (2007). https://doi.org/10.1532/IJH97.07025

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Key words

  • AML with multilineage dysplasia
  • Children
  • Retrospective analysis