Objective: To explore the prognosis and cytogenetic characteristics of acute erythroid leukemia.
Methods: We selected 55 patients with acute erythroid leukemia and reviewed the cytogenetic characteristics of these cases. With case-control studies, 55 patients were classified as primary or MDS transformed leukemia depending on the absence or presence of MDS history. In addition, we also classified these 55 cases as normal or abnormal karyotype. We analyzed the treatment response to allogenic hematopoietic stem cell transplantation or chemotherapy and the survival and prognosis of all the groups with Kaplan-Meier and Log-Rank.
Results: 45 patients and cytogenetic studies and there were 18 cases with normal karyotypes and 27 cases with aberrant karyotypes. The detection rate of chromosomal abnormality was 60.0%. In the cases with chromosomal abnormality, there were 17 cases with multiple chromosomal abnormality and 10 cases with simple chromosomal abnormality. 10 cases had excess of hypodiploid or hyperdiploid. In 18.5% (5/27) of the cases with aberrant karyotypes 5 chromosomes were involved and in 25.9% (7/27) 7 or 8 chromosomes were involved. The 55 patients were followed up and their treatment response was evaluated. In these patients, total complete remission rate was 63.6%. Among them, the complete remission rate of acute erythroid leukemia with MDS history was lower than that without MDS history (42.8% vs 85.2%, P < 0.05). The complete remission rate of acute erythroid leukemia with aberrant karyotypes was lower than that with normal karyotypes (37.0% vs 83.3%, P < 0.01). The median follow-up was 30 months (3 - 79 months). During follow-up, the overall survival and disease-free survival of the patients with aberrant karyotypes or MDS history who received transplantation were longer than those who received chemotherapy (P < 0.01). Chromosomal abnormality and previous MDS history were the major factors that influenced prognosis. 16 patients received allogeneic haemopoietic stem cell transplantation. Among them, 9 cases had aberrant karyotypes and previous MDS history and 4 cases had no response to chemotherapy. After transplantation, 11 cases survived without any disease. The median survival was 28 months and 2-year survival 68.7% (11/16).
Conclusions: Acute erythroid leukemia patients with aberrant karyotypes or MDS history are usually resistant to chemotherapy. The survival of these patients is short and the prognosis poor. Allogeneic haemopoietic stem cell transplantation could improve survival and prognosis. The patients with aberrant karyotypes or MDS history should receive allogeneic haemopoietic stem cell transplantation as early as possible.