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Acute erythroid leukemia (M6): outcome of bone marrow transplantation
S Killick1, E Matutes, R L Powles
1Leukaemia Unit, The Royal Marsden NHS Trust and Institute of Cancer Research, London, UK. skillick@btinternet.com
Abstract:
Erythroid leukemia is an uncommon form of acute myeloid leukemia (AML) which has previously been associated with a poor prognosis. We present the outcome of 27 patients with AML-M6 (19 de novo and 8 secondary) treated with intensive regimens including bone marrow transplantation (BMT). In the de novo group, median age was 30 years (2-72); 5 cases were under 15 years. Remission rate after induction chemotherapy was 95%. Consolidation in those achieving remission with BMT was 82%. Transplant related mortality was 36%. Median survival for de novo M6 was 2.9 years which was not significantly different to matched controls with AML (non M6). Overall relapse rate was 35%. In contrast, patients with secondary disease had a poor prognosis with lower remission rates (57%) and higher relapse rates (75% of those achieving remission after induction chemotherapy). In our series, the prognosis of patients with AML-M6 was most closely related to age and disease status at presentation (de novo or secondary). The disease is sensitive to AML induction regimens and long-term survival can be achieved with BMT in first complete remission.
Insights
Erythroid leukemia (AML-M6) is rare but treatable with intensive chemotherapy and bone marrow transplantation (BMT). While de novo AML-M6 shows promising survival rates, secondary AML-M6 has a poorer prognosis, highlighting the importance of disease status.
Area of Science:
- Hematology
- Oncology
- Leukemia Research
Background:
- Erythroid leukemia, or acute myeloid leukemia subtype M6 (AML-M6), is an uncommon leukemia subtype.
- Historically, AML-M6 has been associated with a poor prognosis.
Purpose of the Study:
- To evaluate the outcomes of AML-M6 patients treated with intensive chemotherapy and bone marrow transplantation (BMT).
- To compare the prognosis of de novo versus secondary AML-M6.
Main Methods:
- Retrospective analysis of 27 AML-M6 patients (19 de novo, 8 secondary) treated with intensive regimens and BMT.
- Assessment of remission rates, transplant-related mortality, survival, and relapse rates.
Main Results:
- High remission rates (95%) and successful BMT consolidation (82%) were observed in de novo AML-M6 patients.
- Median survival for de novo AML-M6 was 2.9 years, comparable to non-M6 AML.
- Secondary AML-M6 patients exhibited lower remission rates (57%) and higher relapse rates (75%).
- Transplant-related mortality was 36%.
Conclusions:
- AML-M6 is sensitive to standard AML induction regimens.
- Bone marrow transplantation in first complete remission can achieve long-term survival for AML-M6.
- Prognosis is significantly influenced by age and disease status (de novo vs. secondary).