Erythroleukemia shares biological features and outcome with myelodysplastic syndromes with excess blasts: a rationale for its inclusion into future classifications of myelodysplastic syndromes
Por:
Calvo, X, Arenillas, L, Luno, E, Senent, L, Arnan, M, Ramos, F, Teresa Ardanaz, M, Pedro, C, Tormo, M, Montoro, J, Diez-Campelo, M, Arrizabalagall, B, Xicoy, B, Bonanad, S, Jerez, A, Nomdedeu, B, Ferrer, A, Sanz, G, Florensa, L and Grp Espanol Sindromes Mielodisplas
Publicada:
1 dic 2016
Categoría:
Pathology and forensic medicine
Resumen:
Erythroleukemia was considered an acute myeloid leukemia in the 2008
World Health Organization (WHO) classification and is defined by the
presence of >= 50% bone marrow erythroblasts, having <20% bone marrow
blasts from total nucleated cells but >= 20% bone marrow myeloblasts
from nonerythroid cells. Erythroleukemia shares clinicopathologic
features with myelodysplastic syndromes, especially with
erythroid-predominant myelodysplastic syndromes (>= 50% bone marrow
erythroblasts). The upcoming WHO revision proposes to eliminate the
nonerythroid blast cell count rule and to move erythroleukemia patients
into the appropriate myelodysplastic syndrome category on the basis of
the absolute blast cell count. We conducted a retrospective study of
patients with de novo erythroleukemia and compared their
clinico-biological features and outcome with those of de novo
myelodysplastic syndromes, focusing on erythroid-predominant
myelodysplastic syndromes. Median overall survival of 405
erythroid-predominant myelodysplastic syndromes without excess blasts
was significantly longer than that observed in 57 erythroid-predominant
refractory anemias with excess blasts-1 and in 59 erythroleukemias, but
no significant difference was observed between erythroid-predominant
refractory anemias with excess blasts-1 and erythroleukemias. In this
subset of patients with >= 50% bone marrow erythroblasts and excess
blasts, the presence of a high-risk karyotype defined by the
International Prognostic Scoring System or by the Revised International
Prognostic Scoring System was the main prognostic factor. In the same
way, the survival of 459 refractory anemias with excess blasts-2,
independently of having >= 20% bone marrow blasts from nonerythroid
cells or not, was almost identical to the observed in 59
erythroleukemias. Interestingly, 11 low-blast count erythroleukemias
with 5 to < 10% bone marrow blasts from total nucleated cells showed
similar survival than the rest of erythroleukemias. Our data suggest
that de novo erythroleukemia is in the spectrum of myelodysplastic
syndromes with excess blasts and support its inclusion into future
classifications of myelodysplastic syndromes.
Filiaciones:
Calvo, X:
Hosp del Mar, IMIM Hosp del Mar Res Inst, Lab Citol Hematol, GRETNHE,Serv Patol, Paseo Maritimo 25, Barcelona 08003, Spain
Arenillas, L:
Hosp del Mar, IMIM Hosp del Mar Res Inst, Lab Citol Hematol, GRETNHE,Serv Patol, Paseo Maritimo 25, Barcelona 08003, Spain
Luno, E:
Hosp Univ Cent Asturias, Serv Hematol, Oviedo, Spain
Senent, L:
Hosp Univ La Fe, Serv Hematol, Valencia, Spain
Arnan, M:
ICO Hospitalet de Llobregat, Serv Hematol, Barcelona, Spain
Ramos, F:
Hosp Univ Leon, Serv Hematol, Leon, Spain
Teresa Ardanaz, M:
Hosp Univ Txagorritxu, Serv Hematol, Vitoria, Spain
Pedro, C:
IMIM Hosp del Mar Res Inst, Serv Hematol, Barcelona, Spain
Tormo, M:
Hosp Clin Univ Valencia, Serv Hematol, Valencia, Spain
Montoro, J:
Hosp Univ Vall dHebron, Serv Hematol, Barcelona, Spain
Diez-Campelo, M:
Hosp Univ Salamanca, Serv Hematol, Salamanca, Spain
Arrizabalagall, B:
Hosp Univ Cruces, Serv Hematol, Baracaldo, Spain
Xicoy, B:
ICO Badalona, Serv Hematol, Badalona, Spain
:
Hosp La Ribera, Serv Hematol, Alzira, Spain
Jerez, A:
Hosp Morales Meseguer, Serv Hematol & Oncol Med, IMIB Arrixaca, Murcia, Spain
Nomdedeu, B:
Hosp Clin Barcelona, Serv Hematol, Barcelona, Spain
Ferrer, A:
Hosp del Mar, IMIM Hosp del Mar Res Inst, Lab Citol Hematol, GRETNHE,Serv Patol, Paseo Maritimo 25, Barcelona 08003, Spain
Sanz, G:
Hosp Univ La Fe, Serv Hematol, Valencia, Spain
Florensa, L:
Hosp del Mar, IMIM Hosp del Mar Res Inst, Lab Citol Hematol, GRETNHE,Serv Patol, Paseo Maritimo 25, Barcelona 08003, Spain
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