Clinical observation of 52 patients with acute myeloid leukemia transformed from myelodysplastic syndrome

Abstract

Objective To investigate the clinical features, efficacy and prognosis factors of acute myeloid leukemia (AML) transformed from myelodysplastic syndrome (MDS). Methods The evolution time, clinical characteristics, subtypes, responses to treatment and the related impact factors of 52 patients with AML transformed from MDS were analyzed retrospectively. Results The median evolution time was 6.75 months. Results of univariate analysis showed age≥46 years old, male, IPSS-R karyotype of poor prognosis were significant risk factors of leukemia free survival (LFS). Results of multivariate analysis by Cox model showed that age≥46 years old and IPSS-R karyotype of poor prognosis were independent risk factors for LFS. The subtypes of AML transformed from MDS included M2 (67.31 %, 35 cases), M5 (11.54 %, 6 cases), M4 (9.62 %, 5 cases), M6 (9.62 % , 5 cases) and M1 (1.92 % , 1 case). 17 patients (32.69 %) developed extramedullary infiltration mainly in liver, spleen, lymph nodes, gingival, alimentary tract and tonsil. White blood cell count and neutrophil count were increased alone with transformation to AML compared with those newly diagnosed MDS. The complete remission rate was only 33.3 % (8/24). Conclusions Elderly and IPSS-R karyotype of poor prognosis can increase the risk of MDS evolution to AML, mainly to M2. Extramedullary infiltration was easy to be found in AML transformed from MDS, with low remission rate, high treatment-related mortality and poor prognosis. Key words: Myelodysplastic syndromes; Evolution; Leukemia, myeloid, acute