Re-evaluation of acute erythroid leukemia according to the 2016 WHO classification. (October 2017)

• Record Type: Journal Article
• Authors: Chen, Yan; Pourabdollah, Maryam; Atenafu, Eshetu G.; Tierens, Anne; Schimmer, Aaron; Chang, Hong
• Is Part Of: Leukemia research. Volume 61(2017:Oct.)
• Page Start: 39
• Page End: 43
• Publication Date: 2017-10
• Subjects: Acute erythroid leukemia -- MDS with excess blasts -- WHO classification; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2017.08.011
• Languages: English
• ISSNs: 0145-2126

Abstract

Highlights: The diagnostic criteria for erythroleukemia have been modified. Patients with >20% blasts, of either NEC or ANC, share similar survival outcomes. Cytogenetics remains to be the major risk factor for myeloid neoplasm with EP. Abstract: In the recent update of WHO classification, the definition of myeloid neoplasms with erythroid predominance has been modified shifting the main criteria for calculating blast percentage from non-erythroid cells (NEC) to all nucleated marrow cells (ANC). Thus, the cases previously classified as erythroid/myeloid subtype of acute erythroid leukemia (AEL) based on the 2008 WHO will now be categorized either as myelodysplastic syndrome with excess blasts (MDS-EB) or acute myeloid leukemia, not otherwise specified (AML-NOS). However, the clinical significance of this new classification has not been demonstrated. Thus, we reviewed a leukemia database and reclassified 38 cases previously diagnosed as AEL, erythroid/myeloid subtype, with the consideration of 2016 revision criteria. Twenty seven (71%) of them had >20% blasts in NEC but less than 20% blasts in ANC, and 11 (29%) had >20% in both NEC and ANC. There was no significant difference in overall survivals (OS) among AEL, MDS-EB, and AML-NOS (non-erythroid predominance, NEP). However, AML with myelodysplasia-related changes showed significant shorter OS than AEL, MDS-EB and AML-NOS (NEP). Our results indicate that in myeloid neoplasm with erythroid predominance, patients with >20% blasts, of either NEC or ANC, share similar clinical laboratory features and survival outcomes with AML-NOS.