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The percentage of myeloperoxidase-positive blast cells is a strong independent prognostic factor in acute myeloid leukemia, even in the patients with normal karyotype

Leukemia volume 17, pages 1538–1543 (2003)Cite this article

Abstract

To examine whether the percentage of myeloperoxidase (MPO)-positive blast cells is useful as a prognostic factor for acute myeloid leukemia (AML), cytochemical analysis of MPO was performed in 491 patients who were registered to the Japan Adult Leukemia Study Group-AML92 study. Patients were divided into two using the percentage of MPO-positive blast (high [⩾50%] and low (<50%)). Complete remission rates were 85.4% in the former and 64.1% in the latter (P=0.001). The overall survival (OS) and the disease-free survival (DFS) were significantly better in the high MPO group (48.3 vs 18.7% for OS, and 36.3 vs 20.1% for DFS, P<0.001, respectively). Multivariate analysis showed that both karyotype and the percentage of MPO-positive blast cells were equally important prognostic factors. The high MPO group still showed a better survival even when restricted to the intermediate chromosomal risk group or the patients with normal karyotype (P<0.001). The OS of patients with normal karyotype in the high MPO group was almost equal with that of the favorable chromosomal risk group. The percentage of MPO-positive blast cells is a simple and highly significant prognostic factor for AML patients, and especially useful to stratify patients with normal karyotype.

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Acknowledgements

We appreciate all physicians who participated in this trial. We thank Drs J Taguchi and T Fukushima for providing assistance. This work was supported in part by the grant from the Ministry of Health, Labour and Welfare of Japan.

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Authors and Affiliations

  1. Department of Hematology and Molecular Medicine Unit, Blood Transfusion Service, ,Nagasaki, Japan

    T Matsuo, K Kuriyama, Y Miyazaki, S Yoshida & M Tomonaga

  2. Department of Radiation Epidemiology, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan

    S Honda

  3. First Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Japan

    N Emi

  4. Second Department of Internal Medicine, Mie University School of Medicine, Mie, Japan

    T Kobayashi

  5. Internal Medicine, Saiseikai Maebashi Hospital, Maehashi, Japan

    S Miyawaki

  6. Third Department of Internal Medicine, Gunma University School of Medicine, Gunma, Japan

    T Matsushima

  7. Second Department of Internal Medicine, Okayama University Medical School, Okayama, Japan

    K Shinagawa

  8. Aichi Cancer Center, Aichi, Japan

    R Ohno

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  1. T Matsuo
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Matsuo, T., Kuriyama, K., Miyazaki, Y. et al. The percentage of myeloperoxidase-positive blast cells is a strong independent prognostic factor in acute myeloid leukemia, even in the patients with normal karyotype. Leukemia 17, 1538–1543 (2003). https://doi.org/10.1038/sj.leu.2403010

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