Survival Analysis of 77 Cases of Acute Erythroleukemia in a Single Institution
Xiaohui Zhang, Alan List, Rami Komrokji, Jeffrey E Lancet, Lynn Moscinski, Ling Zhang. H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
Background: Acute erythroleukemia (AEL) is a rare subtype of acute myeloid leukemia (AML).The clinical and pathologic features of this subtype have not been clearly defined. It is not clear what factors are associated with poor prognosis of this disease. We reviewed ten years of AEL cases from the Moffitt Cancer Center, and analyzed the outcome of these cases according to disease subcategory, cytogenetic changes and different therapies.
Design: Cases from the MCC data base from 2001 to 2011 were reviewed, identifying 77 cases of AEL. Pure erythroid leukemia cases were excluded. Upon further review, of the 77 AEL cases, 22 cases were de novo AEL, 27 cases evolved from antecedent MDS (MDS-AEL), and 28 cases were re-categorized into AML-MRC. Pathological and clinical data were collected. Patient survival was analyzed with Kaplan-Meier method from the date of diagnosis until death from any cause or last follow up visit. Survival curves were compared by the logrank test.
Results: The median overall survival of 22 cases of de novo AEL was 25 months, while the median overall survival of 27 cases of MDS-AEL and 28 cases of AML-MRC were both 14 months. Patients with de novo AEL had better prognosis when compared with MDS-AEL and AML-MRC (p=0.07). There were 48 patients who had abnormal karyotype and 33 of them were with complex cytogenetic changes. The 29 patients with normal karyotype had significantly better overall survival than the patients with abnormal or complex karyotypes (p=0.0017, p=0.005, respectively). The most common cytogenetic changes were monosomy7/del(7q) (21 cases), monosomy 5/del(5q) (19 cases), trisomy 8 (13 cases), and abnormalities involving chromosome 19 (12 cases). Taking the therapies the patients had received into consideration, the overall survival was not significantly different among the different groups that received azanucleosides chemotherapy or standard induction therapy with cytarabine and daunorubicin, with or without bone marrow transplant. Again, in the group that had received same therapies, de novo AEL had better overall survival than AEL associated with MDS.
Conclusions: The overall survival of de novo AEL is better than that of AEL arising from MDS. Patients with cytogenetic changes have worse survival rates than the ones with normal karyotypes. Different therapies including azanucleosides chemotherapy, standard induction chemotherapy and bone marrow transplant have not significantly changed the overall survival.
Monday, March 4, 2013 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 244, Monday Morning