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Query: UMLS:C0023467 (acute myeloid leukemia)
 35,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case is described of myelodysplastic syndrome (MDS) refractory anemia type with an excess of blasts in transformation with early leukemic evolution (AML-M1). All bone marrow cells examined showed an unbalanced translocation t(1;7). The karyotype was 45, xy, -21, -7, + der dic t(1;7) (q12;q21). There are reports in the literature of the translocation t(1;7) (p11;p11), which leads to trisomy of the long arms of chromosome #1 and monosomy of the long arms of chromosome #7. In the case here described the breakpoints of the chromosomes involved in the translocation differ from the classic ones: in this case there is trisomy of the region 1q12----1qter and monosomy of the region 7q21----7qter. Some clinical and cytogenetic considerations are suggested.
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PMID:t(1;7) in acute myeloblastic leukemia following myelodysplastic syndrome (RAEB-T). 321 90

In April, 1985, a 60-year-old Japanese male was diagnosed as having refractory anemia with an excess of blasts (RAEB). He thus was treated solely with blood transfusions until June, 1986, when a new diagnosis revealed that his illness had been transformed into acute myelogenous leukemia (M2). Chromosome analysis at the initial diagnosis had revealed a normal male karyotype. When the subsequent diagnosis of AML was made, however, a chromosomal abnormality [46, XY, -20, +der (20) t (?8;20) (q22;p13)] was detected. Myelodysplastic syndrome (MDS) in patients evidencing a karyotypic alteration from the initial karyotypic findings progresses in severity that includes overt leukemia, and results in a shorter survival than in patients who show no further karyotypic changes. Therefore, the prognosis of patients with MDS can be predicted more accurately by subsequently reanalyzing their chromosomes after the initial analysis, as well as by examining their peripheral blood/counts, and by monitoring bone marrow cytology.
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PMID:[Refractory anemia showing excess of blasts (BAEB) that transformed into acute myelogenous leukemia (AML-M2) with a t (?8;20) chromosomal abnormality]. 323 Jun 41

Two cases of childhood myelodysplastic syndrome with chromosome abnormalities involving band 11p15 are described. The first case, with inv(11)(p15q23), had a complex clinical course; the initial diagnosis was aplastic anemia, then refractory anemia with excess of blasts in transformation (RAEB-t), and finally, before death, chronic myelomonocytic leukemia with hematologic features similar to those of chronic myelogenous leukemia (CML). The second case, with t(4;11)(p13;p15), progressed from RAEB to acute myelogenous leukemia (M2). In the literature, we found 12 patients with nonlymphocytic leukemia and chromosome abnormalities involving band 11p15, including seven cases with t(7;11)(p13-p15;p15); four cases (including the present case 1) showed CML-like hematologic features. It is suggested that translocations involving 11p15 are a nonrandom chromosome abnormality in nonlymphocytic leukemia.
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PMID:Childhood myelodysplastic syndromes with 11p15 translocation. 329 71

The analysis of 288 cases of polycythemia vera (PV) with a minimal follow-up of 10 years enabled us to study the characteristics of acute leukemia as observed in 33 patients (11.4%). In 50% of the patients (16 of 33), the malignant transformation is of the refractory anemia with excess of blasts (RAEB) type. Half of these further transform to acute nonlymphocytic leukemia (ANLL). Their life expectancy is not better than patients who abruptly develop ANLL. Leukemic transformation shows a frequency peak in the eighth year after initial evaluation in PV treated with chemotherapy and in the 11th year in patients treated with radiotherapy. In 30% of the patients myelofibrosis, or the spent phase of PV, is present before the transformation to acute leukemia (AL). This complication is, however, part of the natural history of PV and is observed in 20% of PV patients at 10 years when leukemic transformation is absent. Marrow fibrosis can therefore not be considered as a preleukemic phase. It was also noted that the occurrence of myeloid metaplasia/myelofibrosis is more frequent and begins earlier in patients treated by phlebotomy alone, and who do not transform to leukemia. The clinical characteristics of these AL, including high frequency of partial marrow invasion, difficulties in cytologic classification, a peak incidence similar to that in patients treated by chemotherapy or radiotherapy for a prior malignancy, multiple chromosome abnormalities, and poor response to therapy are all highly suggestive of secondary leukemias.
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PMID:Acute leukemia and myelodysplasia in polycythemia vera. A clinical study with long-term follow-up. 333 54

Chromosome analyses were carried out on bone marrow cells from 43 consecutive patients with primary myelodysplastic syndromes (MDS), classified according to the French-American-British (FAB) cooperative group criteria. The objective was to evaluate the prognostic value of clonal chromosomal abnormalities and of an excess of blasts for early death from acute nonlymphocytic leukemia (ANLL) and/or bone marrow failure (BMF). Patients were subdivided into two main groups: (1) refractory anemia without an excess of blasts (RAWEB), grouping patients with refractory anemia (RA) and refractory anemia with ringed sideroblasts (RARS), and (2) refractory anemia with an excess of blasts (RAEB), grouping patients with refractory anemia with an excess of blasts (RAEB) and refractory anemia with an excess of blasts in transformation (RAEBt). There were 29 patients with RAWEB and 14 with RAEB. The median time of observation was 26 months for RAWEB and 12 months for RAEB. Ten RAWEB patients (34%) and 11 RAEB patients (78%) had clonal chromosomal abnormalities. Among the ten RAWEB patients with clonal abnormalities, one (10%) died from ANLL, while of 19 RAWEB patients with a normal karyotype, two (10%) died from ANLL or BMF. The median survival for patients with RAWEB and an abnormal karyotype was not reached. In contrast, eight of the 11 RAEB patients with clonal chromosomal abnormalities (74%) died from ANLL or BMF. The median survival in this sub-group was 7 months. By using a Cox proportional hazard regression analysis, it was determined that a karyotype abnormality was not a significant predictory of survival once the contribution of the RAWEB/RAEB variable was taken into account. Being in the RAEB group was associated with a relative risk of 10.6 of dying from ANLL or BMF (beta = 2.36, standard error (SE) = 0.68, P = .0001). We conclude that classifying patients according to an excess of blasts will lead to a better prediction of survival than determining karyotype abnormality.
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PMID:Prognostic value of clonal chromosomal abnormalities in patients with primary myelodysplastic syndromes. 336 32

Pluripotent (CFU-MIX), erythroid (BFU-E) and granulocyte/macrophage (CFU-GM) progenitor cells were examined in bone marrow (BM) from 23 patients with myelodysplastic syndromes (MDS). Patients were grouped according to the FAB classification: Refractory anemia (RA), n = 3; RA with ring sideroblasts (RARS), n = 3; RA with excess of blasts (RAEB), n = 8; RA with excess of blasts in transformation (RAEBt), n = 7; chronic myelomonocytic leukemia (CMML), n = 2. In FAB groups RA, RARS, RAEB and RAEBt CFU-GM concentrations were normal or decreased but both CMML-patients had increased CFU-GM values. Abnormal cluster growth was observed in 9 of 23 MDS-patients. BFU-E colony formation was subnormal in all cases. Mixed-colony assay values were at the lower limit of controls in one patient and decreased in the remaining 22 MDS-patients. A similar growth pattern of hemopoietic progenitor cells was observed in 19 patients with acute nonlymphocytic leukemia (ANLL), who were studied for comparison. These data suggest a quantitative or qualitative/functional defect of the pluripotent progenitor cell compartment as the major cause for the cytopenia in MDS-patients.
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PMID:Deficiency of pluripotent hemopoietic progenitor cells in myelodysplastic syndromes. 339 Jun 17

Cytogenetic investigation of the bone marrow cells of an 88-year-old woman with refractory anemia with an excess of blasts in transformation with progression to acute myelocytic leukemia (AML), FAB classification M4, revealed a deleted chromosome #8 with the breakpoint at band q22 as the sole abnormality. This breakpoint is the same as that in t(8;21)(q22;q22), mostly found in patients with AML. This finding is discussed in relation to the possible oncogenesis of AML, which in this case may mean that the deletion of chromosome #8 at band 8q22 and the resultant loss of genetic material with possible antioncogenic activity is the critical event leading to malignant transformation in AML and not the translocation of the end of 21q next to 8q.
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PMID:Deletion (8)(q22) as the only chromosomal abnormality in a patient with RAEB-t with progression to acute myelocytic leukemia. 342 84

A special cultivation technique of separated blasts of peripheral blood in suspension culture has been used for cytogenetic diagnosis of patients suffering from acute nonlymphocytic leukemia, chronic myeloid leukemia, and refractory anemia with excess of blasts. Twenty-three patients were examined; in ten cases isolation of blasts was performed on Ficoll-Verografin and in the remaining 13 patients further separation of T-lymphocyte precursors by means of sheep erythrocytes was performed. Remarkably, a 100% success rate was attained in all cultivations. The optimum harvesting time was 72-96 hours; the rate of cell division per cultivation was determined by means of bromodeoxyuridine incorporation; second mitoses were revealed only after 96-hour cultivation. In all patients, except one, abnormal karyotypic changes were ascertained in separated blasts of peripheral blood cultivations. In most cases the morphology of chromosomes obtained from separated blasts of peripheral blood cultivations was of excellent quality.
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PMID:Cytogenetic study of circulating blasts in leukemias. 347 Jan 20

Four patients with acute myeloid leukemia (AML) and three with myelodysplastic syndrome (MDS) were given low dose cytosine arabinoside (Ara-C) therapy. One patient with de novo AML and two patients having refractory anemia with excess of blasts (RAEB) achieved responses. Although the responses lasted for only a short duration (2-3 months), the therapy was well tolerated and not accompanied by severe complications, while severe cytopenia was a frequent side effect with transfusions being necessary in most patients. This therapy could be clinically effective for certain types of AML and MDS (especially RAEB and RAEB in transformation).
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PMID:Low dose cytosine arabinoside therapy in myelodysplastic syndrome and acute myeloid leukemia. 347 89

Interferon has been reported to have differentiation promoting effects in certain model systems. Because of this and other potentially beneficial effects, a trial of recombinant alpha 2 interferon was undertaken in myelodysplastic syndromes. The study population consisted of 14 patients, subclassified as two refractory anemia (RA), one RA with ring sideroblasts (RARS), nine RA with excess blasts (RAEB), and two chronic myelomonocytic leukemia (CMMoL). The planned dosage schedule was 2.0 MU/M2 t.i.w. sc x 2 weeks q 4 weeks for at least two cycles. No patient achieved the prospective remission criteria, which included sustained blood count improvements. Transient improvements of platelet counts of greater than 50% in baseline were noted in six patients, and a transient antileukemic effect was noted in one patient with CMMoL. Myelodysplastic syndrome patients were found to be sensitive to the count suppressing effects of alpha 2 interferon with greater than 25% suppression of granulocytes, platelets, or reticulocytes transiently noted in 11 patients and decreasing bone marrow cellularity noted in two while on treatment. Because of these effects, dosage adjustments were frequently instituted in the RA, RARS, and RAEB patients. The average dosages and durations of treatment received were thus 1.48 MU/M2 x 19.4 injections for patients with RA, RARS, and RAEB and 2.25 MU/M2 x 27 injections for the CMMoL patients. Progression to acute myeloid leukemia or RAEB in transformation was noted in five patients, and increasing leukocytosis was noted in one CMMoL patient while on protocol. It cannot be determined at this time whether these transformations were accelerated by alpha 2 interferon or represent selection bias in this study population. Although some evidence of beneficial effects was noted, alpha 2 interferon in this dosage and schedule is not a useful treatment for myelodysplastic syndromes.
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PMID:A trial of recombinant alpha 2 interferon in the myelodysplastic syndromes: I. Clinical results. 347 34


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