| Classification of AML*[1,2] |
| Subtype | FAB
Type | Freq
(%)** |
Morphology | MP | SE | NSE |
Immune
Markers | Cytogenetic
Abnormalities |
Acute myeloblastic leukemia
(AML) without maturation*** |
M0 |
2 |
No azurophil granules |
- |
- |
- |
MY7(CD13)
MY9 (CD33) |
- |
Acute myeloblastic leukemia
(AML) |
M1 |
19 |
A few azurophilic granules
or Auer rods |
+/- |
+/- |
- |
MY7 (CD13)
MY9 (CD33)
HLA-DR |
del(5)
del(7)
+8 |
AML, with differentiation |
M2 |
24 |
Some maturation beyond
promyelocytes; Auer rods |
++ |
++ |
- |
MY7
MY9
HLA-DR
MY10(CD34) |
t(8;21)
t(6;9) |
Acute promyelocytic leukemia
(APL) |
M3 |
10 |
Hypergranular promyelocytes;
Auer rods |
+++ |
+++ |
- |
MY7
MY9 |
t(15;17) |
Acute myelomonocytic
leukemia (AMML) |
M4 |
30 |
>=20% monocytes;
monocytoid cells in blood |
++ |
++ |
++ |
MY4(CD14)
MY7
MY9
MO1(CD11b) |
inv(16)
del(16)
t(16;16)
t(4;11) |
Acute monocytic leukemia
(AMOL) |
M5 |
10 |
Monoblastic (M5A)
Promonocytic (M5B) |
-/+ |
- |
+++ |
MO1
MY4
HLA-DR |
t(9;11)
t(10:11) |
Acute erythroleukemia |
M6 |
4 |
Predominance of erythroblasts;
dyserythropoiesis |
- |
- |
- |
Glycophorin A
MY9 |
- |
Acute megakaryocytic
leukemia |
M7 |
1 |
"Dry" aspirate; biopsy
with blasts and dysplastic |
- |
- |
- |
gpIIb/IIIa (CD41a)
HLA-DRą
MY9
MY10(CD34) |
- |
*Findings may be somewhat variable. **In adults. ***IDAMYCIN is not indicated for use in AML FAB M0. Anti-MPO+ (or EM peroxidase +).
Abbreviations: MP, myeloperoxidase; SE, specific esterase (chloracetate); NSE, nonspecific esterase (naphthylbutyrate).
|
| Prognostic Factors in AML[3,4] |
| Factor | Favorable | Unfavorable |
|---|
| Clinical |
Age |
< 45 years |
< 2 years, > 60 years |
Leukemia |
De novo |
Preceding myelodysplasia |
Leukocytosis |
< 25,000/mm≥ |
> 100,000/mm≥ |
Complete remission |
Long duration |
Short duration |
Central nervous system
disease |
Absent |
Present |
Cytoreduction |
Rapid |
Delayed |
| Morphology |
Auer rods |
Present |
Absent |
Eosinophils |
Present |
Absent |
Dysplastic morphology |
Absent |
Present |
FAB type |
M2, M3, M4 |
M0, M1, M5, M6, M7 |
| Surface/Enzyme Markers |
Myeloid |
- |
CD34+ |
HLA-DR |
Negative |
Positive |
TdT |
Absent |
Present (weak correlation) |
Lymphoid |
CD2+ or CD19+ |
Biphenotypic |
Peroxidase |
High score (FABM1) |
Low score (FAB M1) |
Cytogenetics
(often an independent
prognostic factor) |
|
t(15;17),t(8;21),
inv(16)/del(16q)
normal karyotype |
-7,del(7q);-5;3q or 11q23
abnormalities, t(9;22),
+8,20q-, complex karyotypes |
|
