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The applicability of the WHO classification in paediatric AML. A NOPHO-AML study.

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Authors
Sandahl, Julie D
Kjeldsen, Eigil
Abrahamsson, Jonas
Ha, Shau-Yin
Heldrup, Jesper
Jahnukainen, Kirsi
Jónsson, Ólafur G
Lausen, Birgitte
Palle, Josefine
Zeller, Bernward
Forestier, Erik
Hasle, Henrik
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Issue Date
2015-06

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Citation
Br. J. Haematol. 2015, 169 (6):859-67
Abstract
The World Health Organization (WHO) classification of myeloid leukaemia was revised in 2008. It incorporates newly recognized entities and emphasizes the pivotal role of cytogenetic abnormalities. The aim of this study was to evaluate the usability of the WHO classification when applied to a large population-based paediatric acute myeloid leukaemia (AML) cohort. We included children diagnosed with de novo AML, 0-18 years of age from the Nordic countries and Hong Kong from 1993 to 2012. Data were retrieved from the Nordic Society for Paediatric Haematology and Oncology AML database and patients classified according to the WHO 2008 classification. A successful karyotype was available in 97% of the cases. AML with recurrent genetic abnormalities were present in 262 (41%) and 94 (15%) were classified as AML with myelodysplasia-related changes (AML-MDS). WHO classifies patients with monosomy 7 and del(7q) into one group. We found that -7 (n = 14) had significantly poorer outcome than del(7q) (n = 11); 5-year event-free survival 26% vs. 67%, (P = 0·02), and 5-year overall survival 51% vs. 90%, (P = 0·04). The largest group was the highly heterogeneous AML not otherwise specified (NOS) (n = 280) (44%). In conclusion, the WHO classification allocated 15% to AML-MDS, 44% to NOS and grouped together entities with clearly different outcome, therefore limiting the applicability of the current WHO classification in children with AML.
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Additional Links
http://dx.doi.org/ 10.1111/bjh.13366
http://onlinelibrary.wiley.com/doi/10.1111/bjh.13366/epdf
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Archived with thanks to British journal of haematology
ae974a485f413a2113503eed53cd6c53
10.1111/bjh.13366
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English Journal Articles (Peer Reviewed)

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