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Leukemia & Lymphoma Volume 60, 2019 - Issue 5
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Original Article

Clinical and biological characteristics of acute myeloid leukemia with 20–29% blasts: a retrospective single-center study

Chen MeiDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Yanling RenDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
,
Xinping ZhouDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
,
Li YeDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Liya MaDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Yingwan LuoDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Peipei LinDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Weilai XuDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Chenxi LuDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Haiyang YangDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Wenjuan YuDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Liping MaoDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Juying WeiDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
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Jie JinDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaView further author information
&
Hongyan TongDepartment of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; ;Myelodysplastic Syndromes Diagnosis and Therapy Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; ;Institute of Hematology, Zhejiang University, Hangzhou, ChinaCorrespondence[email protected]
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Pages 1136-1145 | Received 10 Feb 2018, Accepted 12 Aug 2018, Published online: 10 Oct 2018
 
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Abstract

It is controversial whether acute myeloid leukemia (AML) patients with 20–29% bone marrow (BM) blasts should be considered AML or myelodysplastic syndromes (MDS). We retrospectively studied 382 patients, including 108 AML with 20–29% BM blasts (AML20–29), 210 AML with ≥30% BM blasts (AML ≥ 30), and 64 MDS with 10–19% BM blasts (MDS-EB2). We found that AML20–29 were more similar to MDS-EB2 in terms of advanced age, less blood count, the increased presence of poor-risk cytogenetics. The frequency of mutated genes in AML20–29 had both the characters of AML and MDS. Median overall survival of AML20–29 and MDS-EB2 were similar and shorter than those of AML ≥ 30 (p = .045). Multivariate analysis showed inferior survival with increased age, low platelet count and FLT3 mutations. Our findings suggest that AML20–29 have clinical features more similar to MDS than AML.

KEYWORDS:

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2018.1515938.

Additional information

Funding

This work was supported by National Natural Science Foundation of China Grants [81700121], Major Program Fund of the Science Technology Department of Zhejiang Province [2013c03043-2].

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