Basophils in acute myeloid leukaemia

Area of Science:

• Hematology
• Oncology
• Cytogenetics

Background:

• Basophilia is a rare finding in acute myeloid leukemia (AML).
• The clinical significance and prognostic implications of basophilia in AML require further investigation.

Purpose of the Study:

• To investigate the incidence, clinical characteristics, and prognostic significance of basophilia in patients with acute myeloid leukemia.
• To analyze the cytogenetic and French-American-British (FAB) classification features associated with basophilia in AML.

Main Methods:

• Retrospective analysis of 750 patients from the Medical Research Council (MRC) 9th AML Trial.
• Evaluation of peripheral blood basophil counts, morphology, cytogenetics, and FAB classification.
• Correlation of basophilia with patient prognosis and response to chemotherapy.

Main Results:

• Thirty-four patients (4.5%) exhibited basophilia (>1% basophils), with counts ranging from 1-27%.
• Abnormal basophil morphology (bizarre granulation, primitive forms) was noted.
• Basophilia was observed across various French-American-British (FAB) classifications, predominantly M2 and M4.
• Karyotypic abnormalities, including 6p, 12p, and Philadelphia chromosome, were present in some cases.
• Basophilia did not appear to confer a worse prognosis overall.
• However, AML cases with 6p abnormalities and basophilia showed resistance to first-line chemotherapy.

Conclusions:

• Basophilia is an infrequent finding in AML with diverse morphological and cytogenetic features.
• While not a universal negative prognostic marker, specific cytogenetic aberrations in basophilic AML may predict treatment resistance.