What is the prognosis of acute myeloid leukemia (AML) with myelodysplasia-related changes (AML-MRC)?

Updated: Feb 25, 2018
  • Author: Angie Duong, MD; Chief Editor: Christine G Roth, MD  more...
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Answer

Answer

Patients with acute myeloid leukemia (AML) with myelodysplasia-related changes (AML-MRC) generally have a poor prognosis. The percentage of patients who achieve complete remission is lower with this form of AML than with other AML types. [17] As mentioned previously, cases arising in association with an myelodysplastic syndrome (MDS) or myelodysplastic/myeloproliferative neoplasm (MDS/MPN) may show slower progression and thus may be less clinically aggressive. The prognosis is also affected by associated cytogenetic abnormalities. The high-risk cytogenetic abnormalities include: -5, -7, del(5q), abn(3q), and complex karyotype. [18]

The lack of prognostic significance of multilineage dysplasia in AML with mutated NPM1 or biallelic CEBPA mutations [1, 7, 8]  support the 2016 World Health Organization (WHO) updated classification of not including these entities within the spectrum of AML-MRC, even if morphologic dysplasia is present.


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