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In Reply:

Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL

Jacob M. Rowe

Rambam Medical Center, Technion Israel Institute of Technology, Haifa, Israel

We thank Drs Darmon and Azoulay for their important comments. Selection bias is inherent and inevitable among patients accrued to clinical trials. It is difficult to capture every patient with a given diagnosis because many patients may be too ill at the time of presentation to be entered. Patients with acute myeloid leukemia (AML) French-American-British (FAB) classification M5 represent a heterogeneous group of patients with acute leukemia.¹ Although some patients present acutely ill and with evidence of extramedullary disease, occasionally requiring care in the medical intensive care unit, others have a more indolent course and are more easily registered to clinical trials. Such selection bias may well influence the outcome of patients in many reports.

Few reports have focused solely on patients with AML FAB M5 treated in a uniform way with contemporary strategies. We emphasize in our manuscript that patients with AML FAB M5 represent a heterogeneous population, cytogenetically, immunologically, and clinically. For many patients, morphology alone does not determine prognosis.

Authors' Disclosures of Potential Conflicts of Interest

The authors indicated no potential conflicts of interest.

REFERENCE

1. Tallman M, Kim H, Paietta E, et al: 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. J Clin Oncol 22:1276-1286, 2004[Abstract/Free Full Text]

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Related Correspondence

• 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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