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Diagnosis and Treatment of Patients With Acute Myeloid Leukemia With Myelodysplasia-Related Changes (AML-MRC).

Authors
  • Arber, Daniel A1
  • Erba, Harry P2
  • 1 Department of Pathology, University of Chicago, Chicago, IL.
  • 2 Department of Medicine, Duke University School of Medicine, Durham, NC.
Type
Published Article
Journal
American Journal of Clinical Pathology
Publisher
Oxford University Press
Publication Date
Nov 04, 2020
Volume
154
Issue
6
Pages
731–741
Identifiers
DOI: 10.1093/ajcp/aqaa107
PMID: 32864703
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Acute myeloid leukemia (AML) with myelodysplasia-related changes (AML-MRC) represents a high-risk and somewhat diverse subtype of AML, and substantial confusion exists about the pathologic evaluation needed for diagnosis, which can include the patient's clinical history, cytogenetic analysis, mutational analysis, and/or morphologic evaluation. Treatment decisions based on incomplete or untimely pathology reports may result in the suboptimal treatment of patients with AML-MRC. Using a PubMed search, diagnosis of and treatment options for AML-MRC were investigated. This article reviews the current diagnostic criteria for AML-MRC, provides guidance on assessments necessary for an AML-MRC diagnosis, summarizes clinical and prognostic features of AML-MRC, and discusses potential therapies for patients with AML-MRC. In addition to conventional chemotherapy, treatment options include CPX-351, a liposomal encapsulation of daunorubicin/cytarabine approved for treatment of adults with AML-MRC; targeted agents for patients with certain mutations/disease characteristics; and lower-intensity therapies for less fit patients. Given the evolving and complex treatment landscape and the high-risk nature of the AML-MRC population, a clear understanding of the pathology information necessary for AML-MRC diagnosis has become increasingly important to help guide treatment decisions and thereby improve patient outcomes. © American Society for Clinical Pathology, 2020.

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