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Published on: March 26, 2018
[Megakaryocytic dysplasia and leukemia associated phenotype in elderly patients with acute myeloid leukemia]
Ji-Xia Qin1, Juan Xu, Xue-Jing Sun
1Department of Hematology, Xuanwu Hospital, Capital University of Medical Science, Beijing 100053, China.
Abstract:
This study was purposed to investigate the megakaryocytic dysplasia and leukemia-associated phenotypes (LAP) of acute myeloid leukemia (AML) in the elderly. The megakaryocytic dysplasia, lineage infidelity, asynchronous antigen expression, total WBC count, and karyotypes were observed in the 147 none M(3)-AML patients. Logistic regression were used to analyzed the difference between the elderly (age > or = 60) and the control. The results showed that out of the total 147 patients (66 elderly patients, and 81 younger patients) 124 patients accepted induction chemotherapy, in which 70 cases achieved complete remission (elderly 18, younger 52, p = 0.008); megakaryocytic dysplasia was found in 32 patients (21.8%); CD33 and CD19/CD7 (lineage infidelity) was co-expressed in 55 patients (37.4%), CD34 and CD11b (asynchronous antigen expression) was co-expressed in 65 patients (44.2%); white blood cell count > 25 x 10(9)/L was found in 52 patients (35.4%). By the Logistic regression, compared with the control, in the elderly patients there was difference in the megakaryocytic dysplasia, and the co-expression of CD33/CD19/CD7 and CD34/CD11b (OR = 4.315, 2.761, 0.397; p = 0.001, 0.006, 0.020), but there was no difference in the total WBC count and karyotypes (OR = 0.802, 1.096; p = 0.646, 0.813). It is concluded that the incidence of megakaryocytic dysplasia, such as lineage infidelity, and asynchronous antigen expression, in elderly patients is higher than that in younger patients.
Insights
Elderly acute myeloid leukemia (AML) patients show higher rates of megakaryocytic dysplasia and aberrant antigen expression compared to younger individuals. These findings highlight key differences in disease presentation in older adults.
Area of Science:
- Hematology
- Oncology
- Geriatrics
Context:
- Acute myeloid leukemia (AML) presents unique challenges in elderly patients.
- Understanding age-related differences in AML phenotypes is crucial for tailored treatment strategies.
Purpose:
- To investigate the prevalence of megakaryocytic dysplasia and leukemia-associated phenotypes (LAP) in elderly AML patients.
- To compare these findings with those in younger AML patients.
Summary:
- The study analyzed 147 non-M3 AML patients, comparing 66 elderly (≥60 years) with 81 younger individuals.
- Elderly patients exhibited significantly higher incidences of megakaryocytic dysplasia (OR=4.315) and co-expression of CD33/CD19/CD7 (lineage infidelity, OR=2.761) and CD34/CD11b (asynchronous antigen expression, OR=0.397).
- No significant differences were observed in total white blood cell count or karyotypes between the age groups.
Impact:
- Identifies specific phenotypic differences in AML among the elderly, including increased megakaryocytic dysplasia and aberrant antigen expression.
- Suggests potential implications for diagnostic and therapeutic approaches in geriatric oncology.
- Highlights the need for further research into the mechanisms driving these age-related variations in AML.
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