Ritter J, Vormoor J, Creutzig U, Schellong G
BFM-AML Study Group, Universitätskinderklinik Münster, Federal Republic of Germany.
Med Pediatr Oncol. 1989;17(3):202-9. doi: 10.1002/mpo.2950170307.
The prognostic significance of Auer rods in predicting response rate and remission duration was investigated in 257 patients of the two West German acute myelogenous leukemia (AML) studies BFM-78 and -83. Auer rods were found in 129 children (50%) in the initial bone marrow smear. The incidence was higher in myeloid subtypes M1 (63%) and M2 (78%) compared with subtypes M4 (47%) and M5 (5%) with monocytic differentiation. In both studies, the remission rate was significantly higher in patients with Auer rods (P = 0.01), and in the study AML-BFM-83 a significantly longer remission duration was evaluated for Auer rod-positive patients (P = 0.007). In the M1 type, Auer rods were of high prognostic significance regarding both the induction success (P = 0.003) and the remission duration (P = 0.004), whereas no significant differences between Auer rod-positive and -negative patients in other subtypes were found. Occurrence of Auer rods was independent of hyperleukocytosis, the most powerful prognostic parameter in the studies AML-BFM-78 and -83, whereas absence of Auer rods was associated with the AML risk group M5. In the M1 type, Auer rod-negative leukemias appears to represent cases of poorly differentiated AML. Auer rods were therefore useful in differentiating between patients with a poor and a more favorable prognosis, particularly in the M1 type.
在西德两项急性髓性白血病（AML）研究BFM - 78和 - 83的257例患者中，研究了奥厄小体在预测缓解率和缓解持续时间方面的预后意义。在初始骨髓涂片检查中，129名儿童（50%）发现有奥厄小体。与具有单核细胞分化的M4（47%）和M5（5%）亚型相比，髓系亚型M1（63%）和M2（78%）中奥厄小体的发生率更高。在两项研究中，有奥厄小体的患者缓解率显著更高（P = 0.01），并且在AML - BFM - 83研究中，奥厄小体阳性患者的缓解持续时间显著更长（P = 0.007）。在M1型中，奥厄小体在诱导缓解成功（P = 0.003）和缓解持续时间（P = 0.004）方面具有很高的预后意义，而在其他亚型中，奥厄小体阳性和阴性患者之间未发现显著差异。奥厄小体的出现与白细胞增多症无关，白细胞增多症是AML - BFM - 78和 - 83研究中最有力的预后参数，而无奥厄小体与AML风险组M5相关。在M1型中，无奥厄小体的白血病似乎代表了低分化AML病例。因此，奥厄小体有助于区分预后不良和预后较好的患者，特别是在M1型中。
