Acute Myeloid Leukemia (AML) In Elderly: Cytogenetic Characteristics of Patients Treated At Hematology and Pediatric Oncology Center in Casablanca

Abstract

AIM:The goals of this paper are: to report the incidence of AML in elderly, to describe cytogenetic characteristics of this population, to observe rare and novel cytogenetic abnormalities and lastly, to compare our finding with that previously reported in the literature.METHODS:We conducted a retrospective analysis of 283 patients with acute myeloid leukaemia (AML) treated in our unit, we will report the incidence of AML in elderly, describe cytogenetic characteristics of this population, observe rare and novel cytogenetic abnormalities and compare our finding with that previously reported in the literature.RESULTS:Among the 283 patients, 157 (54.4%) patients performed the karyotype, the cytogenetic analysis failed in 17 cases (11%). Prognostic group distribution was found to be favorable in 8 patients (6%) with 6 cases of t (8; 21) and 2 cases of inv (16), intermediate group in 94 patients (67%), including 58 cases (41,5%) with a normal karyotype, and an unfavorable group in 38 patients (27%) including complex karyotype (15%), -5 or del 5q (3%), -7 or del 7q (3.5%), t (9; 22) (2%). Some rare anomalies were observed.CONCLUSION:However, the occurrence of a complex karyotype was more frequent than younger patients. In our unit, elderly benefit from supportive care, our study shows that it is a heterogeneous group and our treatment approach have to change especially for the patient from favourable risk group who can benefit from intensive chemotherapy. We have to improve our diagnosis with including molecular genetics that provides a documented substrate for a thoughtfully considered treatment plan.

Patterns of use of biological and genetic markers for chronic lymphocytic leukemia and acute myeloid leukemia in Puerto Rico

“…This finding is consistent with other studies that reported a normal karyotype in 40% to 48% of patients with AML 48–51 . However, a complex karyotype (≥3 clonal abnormalities) was detected in 27% of the patients who received the test, which is higher than that found in the previous studies 50,52,53 . A possible explanation for these results is that more than 55% of the patients in this study with AML were 65 years or older.…”

“…[48][49][50][51] However, a complex karyotype (≥3 clonal abnormalities) was detected in 27% of the patients who received the test, which is higher than that found in the previous studies. 50,52,53 A possible explanation for these results is that more than 55% of the patients in this study with AML were 65 years or older. Studies have shown that older patients have more complex karyotypes than younger patients.…”

Leucemia mieloide aguda en adulto mayor comórbido. A propósito de un caso

“…(5)(6)(7) En su desarrollo se produce la pérdida de respuesta a los reguladores normales de la proliferación celular en la medula ósea; lo que lleva a una aceleración del incremento de la población de células hemáticas inmaduras, desplazándose a la población celular normal, produciéndose una falla medular además de una infiltración extramedular que puede afectar el bazo, hígado, piel y sistema nervioso central. (2,6) La exposición reiterada al benceno está identificada como un potencial factor de riesgo de LMA, debido a la capacidad de dañar el ADN de las células normales de la médula ósea. Otra posible causa se ha identificado en el tratamiento de quimioterapia (en especial con fármacos alquilantes o inhibidores de la topoisomerasa II) o de radioterapia de otros tipos de cáncer como el linfoma, el mieloma y el de seno.…”

“…Su tratamiento es complejo sobre todo al asociarse con comorbilidad y fragilidad. (1,2) Aproximadamente, el 70-80% de los pacientes menores de 60 años logra remisión completa, su supervivencia global por 5 años se establece en el 40-45%, pero la mediana al respecto se establece en un año. (1) Las expectativas para estos pacientes no han cambiado en las tres últimas décadas, siendo peor en aquellos con perfil citogenético desfavorable asociado con el detrimento de la respuesta inmunitaria secundaria al proceso de inmunoscenecencia.…”