The contribution of blast cell properties to outcome variation in acute
myeloblastic leukemia (AML)
EA McCulloch, JE Curtis, HA Messner, JS Senn and TP Germanson
The blast cell population in AML includes progenitors capable of colony
formation in culture. Certain properties of these progenitors have been
determined, including their capacity for self-renewal and their
sensitivities to the chemotherapeutic drugs cytosine arabinoside (Ara- C)
and adriamycin (Adria). Wide patient to patient variation was found in
these properties, although they were stable during the course of the
disease in each patient. We tested the properties, together with clinical
risk factors, as attributes contributing to the variation in remission
induction and survival. As univariate parameters, self- renewal and Ara-C
sensitivity contributed to remission induction, but only self-renewal was
related to survival. In multivariate analysis, self-renewal, age and
percentage blasts in the marrow contributed to outcome variation; drug
sensitivities were not significant. We conclude that self-renewal, a
biological property of malignant AML clones, although measured in culture,
plays a significant role in determining response to treatment and survival
in AML.
Volume 59,
Issue 3,
pp. 601-608,
03/01/1982
Copyright © 1982 by The American Society of Hematology