Acute myeloid leukemia (AML) is characterized by an increasein the number of myeloid cells in the marrow and an arrest intheir maturation, frequently resulting in hematopoietic insufficiency(granulocytopenia, thrombocytopenia, or anemia), with or withoutleukocytosis. In the United States, the annual incidence ofAML is approximately 2.4 per 100,000,1 and it increases progressivelywith age, to a peak of 12.6 per 100,000 adults 65 years of ageor older. Until the 1970s, the diagnosis was based solely onthe pathological and cytologic examination of bone marrow andblood. Five-year survival rates during this period were lessthan 15 . . . [Full Text of this Article]
Clinical Presentation
Diagnosis
Molecular Pathogenesis
Alterations of AML1-CBFß
AML with Alterations of the Mixed-Lineage Leukemia Gene
Prognostic Factors
Secondary AML
Treatment
Induction of Remission
Postinduction Therapy
Allogeneic Bone Marrow Transplantation
Autologous Bone Marrow Transplantation
Chemotherapy
Relapse
Older Patients with AML
Use of Hematopoietic Growth Factors
Conclusions
Source Information
From the Department of Hematology, Erasmus University and University Hospital Rotterdam, Rotterdam, the Netherlands (B.L.); the Department of Pathology and Laboratory Medicine, St. Jude Children's Research Hospital, Memphis, Tenn. (J.R.D.); and the Department of Hematology, University of Wales, College of Medicine, Cardiff, United Kingdom (A.B.).
Address reprint requests to Dr. Löwenberg at the Department of Hematology, University Hospital Rotterdam, P.O. Box 5201, 3008 AE Rotterdam, the Netherlands.
References
Related Letters:
Acute Myeloid Leukemia
Clarke C. A., Glaser S. L., Löwenberg B., Burnett A. K.
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N Engl J Med 2000;
342:358-359, Feb 3, 2000.
Correspondence
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(2002). Preferential induction of apoptosis for primary human leukemic stem cells. Proc. Natl. Acad. Sci. USA
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Menzin, J., Lang, K., Earle, C. C., Kerney, D., Mallick, R.
(2002). The Outcomes and Costs of Acute Myeloid Leukemia Among the Elderly. Arch Intern Med
162: 1597-1603
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Matsui, W. H., Gladstone, D. E., Vala, M. S., Barber, J. P., Brodsky, R. A., Smith, B. D., Jones, R. J.
(2002). The Role of Growth Factors in the Activity of Pharmacological Differentiation Agents. Cell Growth Differ.
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Thiede, C., Steudel, C., Mohr, B., Schaich, M., Schakel, U., Platzbecker, U., Wermke, M., Bornhauser, M., Ritter, M., Neubauer, A., Ehninger, G., Illmer, T.
(2002). Analysis of FLT3-activating mutations in 979 patients with acute myelogenous leukemia: association with FAB subtypes and identification of subgroups with poor prognosis. Blood
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Spisek, R., Chevallier, P., Morineau, N., Milpied, N., Avet-Loiseau, H., Harousseau, J.-L., Meflah, K., Gregoire, M.
(2002). Induction of Leukemia-specific Cytotoxic Response by Cross-Presentation of Late-Apoptotic Leukemic Blasts by Autologous Dendritic Cells of Nonleukemic Origin. Cancer Res.
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Countouriotis, A., Moore, T. B., Sakamoto, K. M.
(2002). Cell Surface Antigen and Molecular Targeting in the Treatment of Hematologic Malignancies. Stem Cells
20: 215-229
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Benekli, M., Xia, Z., Donohue, K. A., Ford, L. A., Pixley, L. A., Baer, M. R., Baumann, H., Wetzler, M.
(2002). Constitutive activity of signal transducer and activator of transcription 3 protein in acute myeloid leukemia blasts is associated with short disease-free survival. Blood
99: 252-257
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Sperr, W. R., Jordan, J.-H., Baghestanian, M., Kiener, H.-P., Samorapoompichit, P., Semper, H., Hauswirth, A., Schernthaner, G.-H., Chott, A., Natter, S., Kraft, D., Valenta, R., Schwartz, L. B., Geissler, K., Lechner, K., Valent, P.
(2001). Expression of mast cell tryptase by myeloblasts in a group of patients with acute myeloid leukemia. Blood
98: 2200-2209
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Kottaridis, P. D., Gale, R. E., Frew, M. E., Harrison, G., Langabeer, S. E., Belton, A. A., Walker, H., Wheatley, K., Bowen, D. T., Burnett, A. K., Goldstone, A. H., Linch, D. C.
(2001). The presence of a FLT3 internal tandem duplication in patients with acute myeloid leukemia (AML) adds important prognostic information to cytogenetic risk group and response to the first cycle of chemotherapy: analysis of 854 patients from the United Kingdom Medical Research Council AML 10 and 12 trials. Blood
98: 1752-1759
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Linenberger, M. L., Hong, T., Flowers, D., Sievers, E. L., Gooley, T. A., Bennett, J. M., Berger, M. S., Leopold, L. H., Appelbaum, F. R., Bernstein, I. D.
(2001). Multidrug-resistance phenotype and clinical responses to gemtuzumab ozogamicin. Blood
98: 988-994
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Sievers, E. L., Larson, R. A., Stadtmauer, E. A., Estey, E., Lowenberg, B., Dombret, H., Karanes, C., Theobald, M., Bennett, J. M., Sherman, M. L., Berger, M. S., Eten, C. B., Loken, M. R., van Dongen, J. J.M., Bernstein, I. D., Appelbaum, F. R.
(2001). Efficacy and Safety of Gemtuzumab Ozogamicin in Patients With CD33-Positive Acute Myeloid Leukemia in First Relapse. JCO
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Shapiro, C. L., Recht, A.
(2001). Side Effects of Adjuvant Treatment of Breast Cancer. NEJM
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Bross, P. F., Beitz, J., Chen, G., Chen, X. H., Duffy, E., Kieffer, L., Roy, S., Sridhara, R., Rahman, A., Williams, G., Pazdur, R.
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van der Velden, V. H. J., te Marvelde, J. G., Hoogeveen, P. G., Bernstein, I. D., Houtsmuller, A. B., Berger, M. S., van Dongen, J. J. M.
(2001). Targeting of the CD33-calicheamicin immunoconjugate Mylotarg (CMA-676) in acute myeloid leukemia: in vivo and in vitro saturation and internalization by leukemic and normal myeloid cells. Blood
97: 3197-3204
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Mrozek, K., Prior, T. W., Edwards, C., Marcucci, G., Carroll, A. J., Snyder, P. J., Koduru, P. R.K., Theil, K. S., Pettenati, M. J., Archer, K. J., Caligiuri, M. A., Vardiman, J. W., Kolitz, J. E., Larson, R. A., Bloomfield, C. D.
(2001). Comparison of Cytogenetic and Molecular Genetic Detection of t(8;21) and inv(16) in a Prospective Series of Adults With De Novo Acute Myeloid Leukemia: A Cancer and Leukemia Group B Study. JCO
19: 2482-2492
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de Lange, P., Segeren, C. M., Koper, J. W., Wiemer, E., Sonneveld, P., Brinkmann, A. O., White, A., Brogan, I. J., de Jong, F. H., Lamberts, S. W. J.
(2001). Expression in Hematological Malignancies of a Glucocorticoid Receptor Splice Variant That Augments Glucocorticoid Receptor-mediated Effects in Transfected Cells. Cancer Res.
61: 3937-3941
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Stucki, A., Rivier, A.-S., Gikic, M., Monai, N., Schapira, M., Spertini, O.
(2001). Endothelial cell activation by myeloblasts: molecular mechanisms of leukostasis and leukemic cell dissemination. Blood
97: 2121-2129
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Ferrara, F. F., Fazi, F., Bianchini, A., Padula, F., Gelmetti, V., Minucci, S., Mancini, M., Pelicci, P. G., Coco, F. L., Nervi, C.
(2001). Histone Deacetylase-targeted Treatment Restores Retinoic Acid Signaling and Differentiation in Acute Myeloid Leukemia. Cancer Res.
61: 2-7
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Bruserud, O., Gjertsen, B. T., Foss, B., Huang, T.-S.
(2001). New Strategies in the Treatment of Acute Myelogenous Leukemia (AML): In Vitro Culture of AML Cells--The Present Use in Experimental Studies and the Possible Importance for Future Therapeutic Approaches. Stem Cells
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Bruserud, O., Gjertsen, B. T., Huang, T.-s.
(2000). Induction of Differentiation and Apoptosis-- A Possible Strategy in the Treatment of Adult Acute Myelogenous Leukemia. The Oncologist
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Maeda, T., Towatari, M., Kosugi, H., Saito, H.
(2000). Up-regulation of costimulatory/adhesion molecules by histone deacetylase inhibitors in acute myeloid leukemia cells. Blood
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Bruserud, O., Tjønnfjord, G., Gjertsen, B. T., Foss, B., Ernst, P.
(2000). New Strategies in the Treatment of Acute Myelogenous Leukemia: Mobilization and Transplantation of Autologous Peripheral Blood Stem Cells in Adult Patients. Stem Cells
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Reddy, V., Moreb;, J., Padro, T., Berdel, W. E., Buchner, T., Mesters, R. M.
(2000). Prognostic correlation of increased angiogenesis in acute myeloid leukemia with cytogenetics. Blood
96: 1617-1618
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Bruserud, O., Gjertsen, B. T.
(2000). New Strategies for the Treatment of Acute Myelogenous Leukemia: Differentiation Induction--Present Use and Future Possibilities. Stem Cells
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Era, T., Witte, O. N.
(2000). Regulated expression of P210 Bcr-Abl during embryonic stem cell differentiation stimulates multipotential progenitor expansion and myeloid cell fate. Proc. Natl. Acad. Sci. USA
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Clarke, C. A., Glaser, S. L., Lowenberg, B., Burnett, A. K.
(2000). Acute Myeloid Leukemia. NEJM
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