Acute Erythroleukemia: Evaluation of 48 Cases With Reference to Classification, Cell Proliferation, Cytogenetics, and Prognosis

Mazzella, Fermina M.; Kowal-Vern, Areta; Shrit, M. Atef; Wibowo, Arif; Rector, James T.; Cotelingam, James D.; Collier, Joel H.; Mikhael, Anwar; Cualing, Hernani; Schumacher, H. Ralph

doi:10.1093/ajcp/110.5.590

Cited by 63 publications

(44 citation statements)

References 4 publications

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“…The cases were divided into three groups, based on a 500-cell count performed on the bone marrow aspirate smears, as previously described (6). All cases had normal serum vitamin B 12 and folate levels and characteristically displayed more than 50% erythroid component.…”

Section: Case Classificationmentioning

confidence: 99%

“…Review of pertinent clinical information, including medical history, toxin exposure (7,8), alcohol use, cytogenetic analyses, prior and subsequent use of chemotherapy, and survival from the time of diagnosis of acute leukemia, was performed for all cases through chart review and contact with the Tumor Registry of each participating institution, as previously described (6).…”

Section: Case Analysismentioning

confidence: 99%

“…Demographic data, significant medical history, cytogenetic analyses, and clinical presentation of these patients have been reported (6). The pertinent clinical findings for each patient are summarized in Table 1.…”

Section: Clinical Datamentioning

confidence: 99%

“…The pertinent clinical findings for each patient are summarized in Table 1. Significant is that acute erythroleukemia has been shown to evolve frequently from a prior myelodysplastic syndrome, suggesting that it is frequently a therapy-induced or myelodysplastic syndrome-derived acute leukemia (6,12). In addition, approximately half of all patients with acute erythroleukemia of all subtypes have a history of toxin and/or alcohol exposure (6).…”

Section: Clinical Datamentioning

confidence: 99%

“…Significant is that acute erythroleukemia has been shown to evolve frequently from a prior myelodysplastic syndrome, suggesting that it is frequently a therapy-induced or myelodysplastic syndrome-derived acute leukemia (6,12). In addition, approximately half of all patients with acute erythroleukemia of all subtypes have a history of toxin and/or alcohol exposure (6). Analysis of these poor prognostic indicators and their relationship to the various subtypes has been reported (6,12).…”

Section: Clinical Datamentioning

confidence: 99%

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Effects of Multidrug Resistance Gene Expression in Acute Erythroleukemia

et al. 2000

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Acute erythroleukemia is a relatively rare disorder of a multilineal nature. Patients with this type of leukemia traditionally have been treated with a standard myeloid protocol, with a wide variation in prognosis between M6a, which has a similar prognosis to acute myelogenous leukemias, and M6b, with an extremely poor outcome despite aggressive therapy.Forty-eight archival cases of acute erythroleukemia, subtypes M6a (the traditional FAB-M6), M6b (pure erythroleukemia), and M6c (>30% myeloblasts and >30% pronormoblasts by FAB exclusion criteria), were evaluated for multidrug resistance gene (MDR-1) status. Findings were correlated with clinical course and karyotypes.Immunohistochemical stain for the protein product of MDR-1, P-glycoprotein, was variably positive in 11 of 23 patients with M6a, as well as in all of the patients with M6b (strongly positive) and M6c (weakly positive). P-glycoprotein expression positively correlated with unfavorable cytogenetic aberrations, poor response to chemotherapeutic agents, and short survival. Most significant was that P-glycoprotein expression demonstrated a negative additive effect on response to treatment and prognosis with unfavorable cytogenetic anomalies. P-glycoprotein expression and multiple cytogenetic anomalies most probably contribute to the resistance to chemotherapy and poor survival characteristic of the patients with M6b (mean survival

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Section: Case Classificationmentioning

confidence: 99%

Section: Case Analysismentioning

confidence: 99%

Section: Clinical Datamentioning

confidence: 99%

Section: Clinical Datamentioning

confidence: 99%

Section: Clinical Datamentioning

confidence: 99%

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Effects of Multidrug Resistance Gene Expression in Acute Erythroleukemia

et al. 2000

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Diagnosis and characterization of acute erythroleukemia subsets by determining the percentages of myeloblasts and proerythroblasts in 69 cases

et al. 2000

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Acute erythroleukemia (FAB M6) is a rare heterogeneous disease with an increase in red cell precursors and myeloblasts. Three subsets have been described: M6A (myeloblast-rich erythroleukemia); M6B (proerythroblast-rich erythroleukemia); and M6C (myeloblast- and proerythroblast-rich mixed variant). This study was undertaken to define and compare the clinical courses and survival outcomes among M6A, M6B, and M6C variants of erythroleukemia. Sixty-nine cases of M6 leukemia were categorized as consisting of >/=50% erythroid of all nucleated cells and M6A with >/=30% myeloblasts/nonerythroid component; M6B with >/=30% proerythroblasts/erythroid component; and M6C with >/=30% myeloblasts and >/=30% proerythroblasts. The demographics, cell type distribution, and survival (mean +/- sd) of these groups were compared. There were 32 M6A, 26 M6B, and 11 M6C patients. No significant difference was seen among the groups in age, sex, or treatment. Compared to M6A, both the M6B (P< 0.0001) and M6C (P< 0.0001) variants showed a statistically significant increase in the percentage of bone marrow erythroid cells, proerythroblasts, and the proerythroblasts/erythroid ratios. Comparing the groups for survival, M6B (3 +/- 3.6 months) versus M6A (25 +/- 28 months), P< 0. 002, and M6C (10 +/- 13 months) versus M6A, P< 0.01 had a poorer prognosis. Calculating the proerythroblasts as a component of total bone marrow erythroids provides a complimentary method for delineating the pure red cell erythroleukemia (M6B) and mixed variant (M6C), similar to that for the myeloid/erythroid (M6A) leukemia. Now that it is possible to delineate erythroleukemia subtypes, innovative treatments are indicated to target the malignant erythroid population, which is resistant to myeloid-based therapies.

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Acute Myeloid Leukemias

Valli¹

2007

Veterinary Comparative Hematopathology

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Acute Erythroleukemia: Evaluation of 48 Cases With Reference to Classification, Cell Proliferation, Cytogenetics, and Prognosis

Abstract: A b s t r a c t We evaluated 48 archival cases of acute erythroleukemia and divided them into 3 groups: M6a

Cited by 63 publications

References 4 publications

Effects of Multidrug Resistance Gene Expression in Acute Erythroleukemia

Effects of Multidrug Resistance Gene Expression in Acute Erythroleukemia

Diagnosis and characterization of acute erythroleukemia subsets by determining the percentages of myeloblasts and proerythroblasts in 69 cases

Acute Myeloid Leukemias

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