The predictive value of morphological findings in early diagnosis of acute myeloid leukemia with recurrent cytogenetic abnormalities. (December 2018)

• Record Type: Journal Article
• Authors: Jakovic, Ljubomir; Bogdanovic, Andrija; Djordjevic, Vesna; Dencic-Fekete, Marija; Kraguljac-Kurtovic, Nada; Knezevic, Vesna; Tosic, Natasa; Pavlovic, Sonja; Terzic, Tatjana
• Is Part Of: Leukemia research. Volume 75(2018)
• Page Start: 23
• Page End: 28
• Publication Date: 2018-12
• Subjects: AML acute myeloid leukemia -- APL acute promyelocytic leukemia -- AML-RCA AML with recurrent cytogenetic abnormalities -- CI Confidence interval -- ELN European LeukemiaNet -- FAB French-American-British -- ISCN International System for Nomenclature in Human Cytogenetics -- NLR negative likelihood ratio -- NOS not otherwise specified -- NPV negative predictive value -- PLR positive likelihood ratio -- PMC promyelocytes -- PPV positive predictive value -- RT-PCR reverse transcriptase-polymerase chain reaction -- WP10 Work Package 10 -- WHO World Health Organization; Acute myeloid leukemia -- Recurrent cytogenetic abnormalities -- Cytomorphological characteristics -- WHO classification; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2018.10.017
• Languages: English
• ISSNs: 0145-2126

Abstract

Highlights: Morphologic accuracy in evaluation of AML-RCA. Morphology is relevant and fast evaluation method in diagnosing of APL. Morphological assessment is starting point in a stepwise diverse diagnostic algorithm. Abstract: This study explores cytomorphologic features and their predictive role for early identification of acute myeloid leukemia (AML) with morphological distinctive recurrent cytogenetic abnormalities (RCA): t(15;17), t(8;21) and inv(16)/t(16;16). We retrospectively evaluated 396 de novo AML cases, diagnosed and treated at single institution, between 2013-2017. Specific cytomorphologic features suggesting distinctive AML-RCA were revealed at diagnosis in 62 (15.65%) patients, including AML with t(15;17) in 41 (66.13%), t(8;21) in 13 (20.97%) and inv(16)/t(16;16) in 8 (12.90%). Final diagnoses of AML-RCA according to WHO integrated diagnostic criteria were established in 66 (16.66%) cases, including AML with t(15;17) 40 (60.60%), t(8;21) 17 (25.76%), and inv(16)/t(16;16) 9 (13.64%). Discordance between cytomorphological and other integrated criteria was detected as missed/wrong-call in 0/1 for t(15;17), 6/2 for t(8;21) and 2/1 for inv(16)/t(16;16). The cytomorphological accuracy was 97.56% (40/41) for t(15;17), 57.89% (11/19) for t(8;21) and 70% (7/10) for inv (16)/t(16;16). Positive/negative predictive values of cytomorphological evaluation were: 97.56%/100% for t(15;17); 84.62%/88.68% for t(8;21); 87.50%/96.65% for inv(16)/t(16;16). Sensitivity/specificity were: 100%/96.15% for t(15;17); 64.10%/95.92% for t(8;21); 77.78%/98.25% for inv(16)/t(16;16). We confirmed that morphology is still a highly relevant evaluation method in diagnosing several common AML-RCAs before completing cytogenetic and molecular studies, enabling early detection, particularly of AML with t(15;17).