Acute myeloid leukaemia with myelodysplastic features in children: A report of Japanese Paediatric Leukaemia/Lymphoma Study Group

Akitoshi Kinoshita, Hayato Miyachi, Hiromichi Matsushita, Miharu Yabe, Tomohiko Taki, Tomoyuki Watanabe, Akiko M. Saito, Daisuke Tomizawa, Takashi Taga, Hiroyuki Takahashi, Hidemasa Matsuo, Kumi Kodama, Kentaro Ohki, Yasuhide Hayashi, Akio Tawa, Keizo Horibe, Souichi Adachi

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Summary: The clinical characteristics and prognostic relevance of acute myeloid leukaemia (AML) with myelodysplastic features remains to be clarified in children. We prospectively examined 443 newly diagnosed patients in a multicentre clinical trial for paediatric de novo AML, and found 'AML with myelodysplasia-related changes' (AML-MRC) according to the 2008 World Health Organization classification in 93 (21·0%), in whom 59 were diagnosed from myelodysplasia-related cytogenetics alone, 28 from multilineage dysplasia alone and six from a combination of both. Compared with 111 patients with 'AML, not otherwise specified' (AML-NOS), patients with 'AML-MRC' presented at a younger age, with a lower white blood cell count, higher incidence of 20-30% bone marrow blasts, unfavourable cytogenetics and a lower frequency of Fms-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD), NPM1 and CEBPA mutations. Complete remission rate and 3-year probability of event-free survival were significantly worse in 'AML-MRC' patients (67·7 vs. 85·6%, P < 0·01, 37·1% vs. 53·8%, P = 0·02, respectively), but 3-year overall survival and relapse-free survival were comparable with 'AML-NOS' patients. By multivariate analysis, FLT3-ITD was solely associated with worse overall survival. These results support the distinctive features of the category 'AML-MRC' even in children.

Original languageEnglish
Pages (from-to)80-86
Number of pages7
JournalBritish Journal of Haematology
Volume167
Issue number1
DOIs
Publication statusPublished - 2014 Oct 1
Externally publishedYes

Keywords

  • Multilineage dysplasia
  • Myelodysplasia
  • Paediatric acute myeloid leukaemia
  • WHO classification

ASJC Scopus subject areas

  • Hematology

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