Mutational features of myelodysplastic syndromes with Auer rods reveal them are more akin to acute myeloid leukemia

Huang, Huijun; Qin, Tiejun; Xu, Zefeng; Shi, Zhongxun; Li, Bing; Pan, Lijuan; Hu, Naibo; Qu, Shiqiang; Huang, Gang; Gale, Robert Peter; Xiao, Zhijian

doi:10.1111/bjh.16326

Cited by 4 publications

(4 citation statements)

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“…NPM1 mutations, common in AML, also occur in persons with MDS, are associated with Auer rods and can rapidly progress to AML [ 13 , 16 ]. Those people were biologically more akin to AML regardless of blast percentage and may benefit from AML therapies [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the revised 4th (2016) and 5th (2022) editions of the World Health Organization classification of myelodysplastic neoplasms

Zhang

Qin

et al. 2022

Leukemia

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We used data from 852 consecutive subjects with myelodysplastic neoplasms (MDS) diagnosed according to the 2016 (revised 4th) World Health Organization (WHO) criteria to evaluate the 2022 (5th) edition WHO classification of MDS. 30 subjects previously classified as MDS with an NPM1 mutation were re-classified as acute myeloid leukaemia (AML). 9 subjects previously classified as MDS-U were re-classified to clonal cytopenia of undetermined significance (CCUS). The remaining 813 subjects were diagnosed as: MDS-5q (N = 11 [1%]), MDS-SF3B1 (N = 70 [9%]), MDS-biTP53 (N = 53 [7%]), MDS-LB (N = 293 [36%]), MDS-h (N = 80 [10%]), MDS-IB1 (N = 161 [20%]), MDS-IB2 (N = 103 [13%]) and MDS-f (N = 42 [5%]) and MDS-biTP53 (N = 53 [7%]). 34 of these subjects came from the 53 (64%) MDS-biTP53 previously diagnosed as MDS-EB. Median survival of subjects classified as MDS using the WHO 2022 criteria was 45 months (95% Confidence Interval [CI], 34, 56 months). Subjects re-classified as MDS-biTP53 and MDS-f had significantly briefer median survivals compared with other MDS sub-types (10 months, [8, 12 months] and 15 months [8, 23 months]). In conclusion, our analyses support the refinements made in the WHO 2022 proposal.

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Section: Discussionmentioning

confidence: 99%

Comparison of the revised 4th (2016) and 5th (2022) editions of the World Health Organization classification of myelodysplastic neoplasms

Zhang

Qin

et al. 2022

Leukemia

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“…However, compared to MDS‐EB‐2 with increased blasts but without Auer rods, they have consistently been shown to have a better prognosis (Table 1). 16–19,21–24 …”

Section: Prognostic Significance In Aml and Mdsmentioning

confidence: 99%

“…Auer rods, as markers of differentiation, have been extensively studied as potential indicators of prognosis in AML and MDS. [16][17][18][19][20][21][22][23][24][25][26] In general, in AML, their presence has been found to correlate with a better prognosis in terms of both remission induction and the remission's duration/stability. Table 1 lists the salient findings of larger studies studying this phenomenon.…”

Section: Prognostic Significance In Aml and Mdsmentioning

confidence: 99%

“…However, compared to MDS-EB-2 with increased blasts but without Auer rods, they have consistently been shown to have a better prognosis (Table 1). [16][17][18][19][21][22][23][24] Post-therapy in AML, the persistence of Auer rods, specifically within blasts, indicates an absence of remission. 28 However, their presence in non-blast cells may not portend the same grim situation.…”

Section: Prognostic Significance In Aml and Mdsmentioning

confidence: 99%

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Auer rods and faggot cells: A review of the history, significance and mimics of two morphological curiosities of enduring relevance

Sehgal

Sharma

2022

European J of Haematology

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Myeloid differentiation in blasts is distinguished by the presence of one or more needle-shaped crystalline structures called Auer rods. Auer rods manifest either alone or as faggot cells (containing bundles of Auer rods) in various types of acute myeloid leukemia (AML), myelodysplastic syndromes (MDS) and myelodysplastic/ myeloproliferative neoplasms (MDS/MPN). Their presence largely portends a better prognosis in AML (as markers of maturation/differentiation) and upstages cases of MDS and MDS/MPN. Observation of these rods in residual blasts in treated cases of AML indicates an absence of remission. This article traces their historical discovery and examines their pathogenetic intricacies, as well as our current understanding of their relevance in myeloid neoplasms. Studies evaluating their prognostic impact in AML and MDS are catalogued. We also discuss a variety of other hematological and non-hematological neoplasms where structures potentially mistakable for Auer rods have been described. Even as the diagnostic approach to hematological malignancies has evolved from a morphology + cytochemistry + immunophenotyping-dependent one in the last century to a predominantly molecular genetics-based classification currently, and even as high-throughput sequencing and structural variation detection techniques surpass morphology in detecting clinically-relevant sub-categories of similar-appearing tumours, we review these curious microscopic structures that have withstood the test of time with respect to their diagnostic relevance.

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Prognostic impact of Auer rods for cytoreductive chemotherapy and myeloablative allogeneic stem cell transplantation in adult patients with myelodysplastic syndrome with excess blasts-2

Wang

Shen

et al. 2022

Ann Hematol

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Mutational features of myelodysplastic syndromes with Auer rods reveal them are more akin to acute myeloid leukemia

Cited by 4 publications

References 15 publications

Comparison of the revised 4th (2016) and 5th (2022) editions of the World Health Organization classification of myelodysplastic neoplasms

Comparison of the revised 4th (2016) and 5th (2022) editions of the World Health Organization classification of myelodysplastic neoplasms

Auer rods and faggot cells: A review of the history, significance and mimics of two morphological curiosities of enduring relevance

Prognostic impact of Auer rods for cytoreductive chemotherapy and myeloablative allogeneic stem cell transplantation in adult patients with myelodysplastic syndrome with excess blasts-2

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