Originally published as JCO Early Release 10.1200/JCO.2004.08.060 on February 17 2004

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Acute Monocytic Leukemia (French-American-British classification M5) Does Not Have a Worse Prognosis Than Other Subtypes of Acute Myeloid Leukemia: A Report From the Eastern Cooperative Oncology Group

From the Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL; Biostatistics, Dana-Farber Cancer Institute, Boston, MA; Our Lady of Mercy Cancer Center, New York Medical College, Bronx, NY; University of Rochester, The James P. Wilmot Cancer Center, Rochester, NY; Mayo Clinic, Rochester, MN; University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL; Rambam Medical Center, Technion Institute of Technology, Haifa, Israel; for the Eastern Cooperative Oncology Group, Brookline, MA

Address reprint requests to Martin S. Tallman, MD, Department of Medicine, Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, 676 N St Clair St, Suite 850, Chicago, IL 60611; e-mail: m-tallman{at}northwestern.edu

PURPOSE: Acute monocytic leukemia is a distinct subtype of acute myeloid leukemia (AML) with characteristic biologic and clinical features. This study was designed to compare the outcome of patients with M5 to that of other subtypes of AML, and to identify differences in M5a and M5b.

PATIENTS AND METHODS: We reviewed all patients with AML M5 entered in three clinical trials for newly diagnosed AML conducted by the Eastern Cooperative Oncology Group between 1989 and 1998. Eighty-one patients, 21 with M5a and 60 with M5b, were identified.

RESULTS: The complete remission rate was 62% for all patients with M5; 52% for patients with M5a and 65% for patients with M5b (P = .3), and 60% for the 1,122 patients with non-M5 AML entered on the same clinical trials (P = .8 for M5 v non-M5). The 3-year disease-free survival was 26% for all M5 patients; 18% for M5a and 28% for M5b (P = .31), and 33% for non-M5 patients (P = .13 for M5 v non-M5). The 3-year overall survival was 31% for all M5 patients; 33% for M5a and 30% for M5b (P = .65), and 30% for non-M5 (P = .74 for M5 v non-M5). The karyotypes of patients with AML M5 were heterogeneous. CD11b was the only leukemic cell antigen expressed differently in M5a (53%) compared to M5b (77%) to a significant degree (P = .02).

CONCLUSION: AML M5 represents an immunologically heterogeneous population similar to non-M5 AML with a prognosis that is not dependent on morphology. The disease-free survival and overall survival of patients with M5a, M5b, and non-M5 appear not to differ with currently available therapy.

Presented in part at the Annual Meeting of the American Society of Hematology, Orlando, FL, December 7-11, 2001.

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

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• Prognosis of Acute Monocytic Leukemia (French-American-British Classification M5)
  Michael Darmon and Elie Azoulay
  JCO 2005 23: 1327 [Full Text]

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