Goasguen J E, Matsuo T, Cox C, Bennett J M
University de Rennes, Hopital-Sud, Rennes, France.
Leukemia. 1992 Jun;6(6):520-5.
Myelodysplastic features and myeloperoxidase (MPO) deficiency have been investigated in a series of 336 cases of de novo acute myeloid leukemia (AML) to clarify their impact on the outcome of such patients and to compare with the previous results from the literature. Dysplastic features were defined according to the FAB criteria. Trilineage disease (TLD) was observed in 11.6% of patients (39 cases), and the complete remission rate (CR) was 56.4% for TLD patients compared to 74.4% for patients without any dysplastic features (p = 0.03). The effects of dysgranulopoiesis (DysM) alone or in combination were assessed using a logistic regression analysis. This analysis revealed that only DysG had any effect on CR rate (p = 0.013). The CR rate for patients with DysG was 56.6% and 71.5% for patients without DysG. We were unable to find any correlation between MPO deficiency, dysplastic features and CR rate. Cytogenetic analysis could be assessed for 119 patients. For patients with DysG, 10 karyotypes were normal and 20 were abnormal compared to 48 normal and 41 abnormal for patients without DysG (p = 0.05). We conclude that the presence of DysG in de novo AML exerts a negative effect on the ability to achieve a CR and is related to a higher frequency of cytogenetic abnormalities.
对336例初发性急性髓系白血病（AML）患者进行了骨髓发育异常特征和髓过氧化物酶（MPO）缺乏情况的研究，以明确它们对此类患者预后的影响，并与文献中的既往结果进行比较。发育异常特征根据FAB标准定义。11.6%的患者（39例）观察到三系疾病（TLD），TLD患者的完全缓解率（CR）为56.4%，而无任何发育异常特征的患者为74.4%（p = 0.03）。使用逻辑回归分析评估单独或联合存在的粒细胞生成异常（DysM）的影响。该分析显示只有DysG对CR率有影响（p = 0.013）。有DysG的患者CR率为56.6%，无DysG的患者为71.5%。我们未能发现MPO缺乏、发育异常特征与CR率之间存在任何相关性。对119例患者进行了细胞遗传学分析。有DysG的患者中，10例核型正常，20例异常，而无DysG的患者中48例正常，41例异常（p = 0.05）。我们得出结论，初发性AML中DysG的存在对实现CR的能力产生负面影响，并且与细胞遗传学异常的较高频率相关。
