Background: Acute myelogenous leukemia (AML) is the most common disease of malignant hemopathy in adult. Although induction therapy induced the long complete remissions, but complications of this intensive therapy is very serious. Objectives: to evaluate the complications of induction chemotherapy in adult patients with acute myelogenous leukemia at Hue central hospital". Subject and method: 30 AML patients aged from 10 to 30 were treated at clinical hematology service, Hue central hospital from Mars, 2005 to July, 2006. The diagnosis of AML based on FAB classification. Induction therapy consisted of a combination of cytarabin 100mglm2/day given by continuous IV over 7 days and daunorubicin 45mg/m2/day for 3 days. Complications were evaluated based on toxicity grade of WHO. \r\n', u'Results: Alopecia was the most common complications (100%) but good recovery. Gastrointestinal toxicity included: nausea and vomiting (6.6%), oral mucositis (40%) and diarrhea (30%) Cerebral hemorrhage due thrombocytopenia (6.66%) and neutropenic septicemia (20%) are the most severe complications. Acute complications on cardio - vascular system were rare and only mild degree. Conclusion: The complications of induction chemotherapy in adult patients with acute myelogenous leukemia occur at many organs with different degrees. Among of them, bone marrow suppression is the most severe complication with cerebral hemorrhage due thrombocytopenia and neutropenic septicemia which are fatal complications in theses patients. \r\n', u'\r\n', u'
Leukemia ; Myeloid ; Acute/ complications ; pathology ; drug therapy

Background: In recent years, Vietnam has applied four methods (morphology, cell chemistry, immune marker classification, cyto genetic) in diagnosis and used multi-chemotherapy in treatment for acute myelogenous leukemia (AML)\r\n', u'Objectives: To initially determine some fusion gene transcripts in the acute myelogenous leukemia patients by applying PCR technique. Subject and method: The study included 19 patients with acute myelogenous leukemia treated in National Institute of Hematology and Blood Transfusion and Bachmai Hospital from April 2007 to August 2007. RNA were extracted from leukemic cells and PCR for AML1/ETO, CBFP/MYH11, PMR/RARa fusion transcript was done. Results: Number of male patients was 6 (32%), female patients was 13 (68%). The average age of these patients was 32.67 \xb113.62. There were three M4, M4eo patients with AML1/ETO gene (accounting for 16%), two M2, M4 patients with CBF/MYH1 gene and type F of genetic modification accounting for 11%), two M3 patients with PMR/RAR\u03b1 and Bcr3 of genetic modification (accounting for 11%). Conclusion: Results of the study did not differ significantly from other researches in the world. This study showed the need of applying the PCR technique in determining fusion gene transcript together with traditional cyto-genetic method.\r\n', u'\r\n', u'
Leukemia ; Myeloid ; Acute/ blood ; pathology ; complications ; Polymerase Chain Reaction

Adolescent ; Humans ; Leukemia, Myeloid, Acute ; etiology ; pathology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; pathology

Background: Aplastic anemia following chemotherapy of acute leukemia is a common complication, which may lead to severe consequences. Objective: To study characteristics of aplastic anemia occurred in ccute myelogenous leukemia (AML) patients, following chemotherapy. Subjects and methods: A prospective study was carried out in 50 AML patients treated at National Institute of Hematology and Blood Transfusion from Aug 2005 to Dec 2006. These patients were treated by induction chemotherapy with "3+7" regime. Result: Aplastic anemia had been seen in 100% patients. Characteristics of this condition were poor marrow cells (average marrow cell count was 15.1\xb112.6 G/l) and strongly decreased counts of hemoglobin, white blood cells and platelets. Hemoglobin, white blood cell and platelet counts at the lowest level were 83.32 g/l; 0.96 G/l; 30.18 G/l; respectively. This situation prolonged for 3-4 weeks and changed into the most severe condition at the end of second week after chemotherapy. Infection frequency was 92%. Conclusion: Aplastic anemia following chemotherapy of AML patients is a common complication with severe consequences such as significant decrease of WBC and platelet counts, which may lead to opportunistic infection. Hence, this complication must be monitored, detected and treated promptly. \r\n', u'\r\n', u'
Leukemia ; Myeloid ; Acute/ pathology ; prevention & ; control ; complications ; drug therapy ; Anemia ; Aplastic/ blood ; complications ; pathology

Myelodysplastic syndrome (MDS) is a clonal hematopoietic stem cell disorder characterized by ineffective hematopoiesis and a risk of transformation into acute leukemia. Approximately 30% of patients with MDS will progress and develop into acute myeloid leukemia (AML), especially in the patients with high-risk MDS, which can be named as secondary acute myeloid leukemia (sAML or MDS/AML). Generally, chemotherapy for sAML hardly has any efficacy. The only way to cure the patients with sAML is allogeneic hematopoietic stem cell transplantation, but unfortunately, only few patients are appropriate for transplantation. So it is important to study the mechanisms of progression of MDS to AML and to explore the potent drug for clinical use. This review summarizes the mechanism of MDS transformation into AML from chromosomal abnormality, aberrant DNA methylation and gene mutation, such as AML1/RUNX1 mutations, FLT3 mutations and PI-PLCβ1 mono-allelic deletion.
Chromosome Aberrations ; DNA Methylation ; Humans ; Leukemia, Myeloid, Acute ; genetics ; pathology ; Myelodysplastic Syndromes ; genetics ; pathology

BACKGROUND: Different criteria have been used to diagnose mixed-phenotype acute leukemia (MPAL), which has impacted the number of individuals diagnosed with this pathology. Better outcomes have been reported when using acute lymphoblastic leukemia (ALL)-type chemotherapy in the treatment of MPAL. METHODS: We compared the outcome of 4 groups of patients with MPAL. Group 1 included patients diagnosed using the 2008/2016 World Health Organization (WHO) classification; group 2 included patients diagnosed using the European Group for the Immunological Characterization of Leukemias (EGIL) criteria; group 3 included patients diagnosed using either the EGIL or the 2008/2016 WHO criteria; and group 4 was comprised of patients diagnosed with MPAL using the EGIL classification only. RESULTS: We found a significantly worse disease-free survival (groups 1-4) and overall survival (OS) (groups 2 and 3) when comparing MPAL patients to other acute leukemia (AL) patients. A significantly better OS was obtained in patients (groups 2-4) treated with ALL-type chemotherapy compared to acute myeloid leukemia (AML)-type regimens. CONCLUSION: In light of these results, and because a trend (P=0.06) was found with regard to a better OS in group 4 when compared to other AL patients, an argument can be made that the 2008/2016 WHO classification is underpowered to diagnose all MPAL cases, potentially resulting in the suboptimal treatment of some individuals with AL.
Classification* ; Disease-Free Survival ; Drug Therapy ; Humans ; Leukemia* ; Leukemia, Myeloid, Acute ; Pathology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; World Health Organization

To investigate the clinical, cellular morphology, immunophenotype, and cytogenetic characteristics of acute myeloid leukemia (AML) which are very similar to the morphological characteristics of prolymphocytic leukemia (PLL), the morphological features of bone marrow cells from patient were observed by light microscope, the immunophenotypes were detected by flow cytometry, the karyotypes were analyzed by conventional cytogenetic method, the hybridization signals were determined by fluorescence in situ hybridization. The results indicated that the clinical features were in accordance with acute leukemia and the immunophenotyping results showed malignant cells originated from myeloid lineage, while the cytomorphology analysis showed that the blastic cells were more like the lymphoid lineage. Trisomy 8 was found in the patient by cytogenetic study, the patient did not show good response to chemotherapy. In conclusion, acute leukemia has high heterogenicity, which could be defined as AML, but more like lymphocytic origination by morphological study. Immunophenotyping analysis could contribute to the final diagnosis of malignant cells.
Adult ; Bone Marrow Examination ; Cytogenetics ; Humans ; Immunophenotyping ; Leukemia, Myeloid, Acute ; immunology ; pathology ; Leukemia, Prolymphocytic ; immunology ; pathology ; Male

A rare case of spinal epidural granulocytic sarcoma (GS) preceding acute myelogenous leukemia is described. A 10-year-old boy presented with lower leg weakness. The initial diagnosis was a histiocytic lymphoma, and he was treated accordingly. No evidence of bone marrow involvement was found at that time. The correct diagnosis of epidural GS was made possible in retrospect by using immunoperoxidase staining for lysozyme fourteen months later when the patient showed the full-blown features of leukemia. This rare tumor should be considered in the differential diagnosis of an epidural mass with cord compression in patients with or even without acute leukemia, because early diagnosis followed by appropriate combined chemotherapy and radiation may obviate surgical intervention and eventually prevent leukemic transformation.
Child ; Epidural Neoplasms/*complications/pathology ; Humans ; Immunoenzyme Techniques ; Leukemia, Myeloid/*complications/pathology ; Leukemia, Myeloid, Acute/*complications/pathology ; Male ; Neoplasms, Second Primary

OBJECTIVEIntermediate-risk acute myeloid leukemia (IR-AML), which accounts for a substantial number of AML cases, is highly heterogeneous. We systematically summarize the latest research progress on the significance of gene mutations for prognostic stratification of IR-AML.

DATA SOURCESWe conducted a systemic search from the PubMed database up to October, 2014 using various search terms and their combinations including IR-AML, gene mutations, mutational analysis, prognosis, risk stratification, next generation sequencing (NGS).

STUDY SELECTIONClinical or basic research articles on NGS and the prognosis of gene mutations in IR-AML were included.

RESULTSThe advent of the era of whole-genome sequencing has led to the discovery of an increasing number of molecular genetics aberrations that involved in leukemogenesis, and some of them have been used for prognostic risk stratification. Several studies have consistently identified that some gene mutations have prognostic relevance, however, there are still many controversies for some genes because of lacking sufficient evidence. In addition, tumor cells harbor hundreds of mutated genes and multiple mutations often coexist, therefore, single mutational analysis is not sufficient to make accurate prognostic predictions. The comprehensive analysis of multiple mutations based on sophisticated genomic technologies has raised increasing interest in recent years.

CONCLUSIONSNGS represents a pioneering and helpful approach to prognostic risk stratification of IR-AML patients. Further large-scale studies for comprehensive molecular analysis are needed to provide guidance and a theoretical basis for IR-AML prognostic stratification and clinical management.

Genomics ; methods ; High-Throughput Nucleotide Sequencing ; Humans ; Leukemia, Myeloid, Acute ; genetics ; pathology ; Mutation ; genetics ; Prognosis

Adolescent ; Child ; Female ; Humans ; Leukemia, Myeloid, Acute ; diagnosis ; drug therapy ; pathology ; Male ; Prognosis