Blood, 15 March 2001, Vol. 97, No. 6, pp. 1898-1898
CORRESPONDENCE
To the editor:
Criteria for the diagnosis of acute megakaryocytic
leukemia
The recent report by Tallman et al1 on the Eastern
Cooperative Oncology Group's experience with acute megakaryocytic
leukemia contains an apparent inconsistency. In the methods section it is stated that the "bone marrow aspirate or biopsy leukemic blast cell population must have represented 30% or more of the myeloid marrow."1(p2406) This widely accepted
French-American-British (FAB) criterion for the diagnosis of acute
granulocytic leukemia, however, does not appear to have been met by
several of the patients listed in Table 1. Patients 2, 12, and 14 are
reported as having only 10%, 5%, and 15% marrow blasts,
respectively, and in an additional 3 patients (10, 11, and 13)
marrow blasts are reported as "NA." How was the diagnosis
established in these patients?
James A. Strauchen
Department of Pathology Mount Sinai School of Medicine
New York, New York
Reference
1.
Tallman MS, Neuberg D, Bennett JM, et al.
Acute megakaryocytic leukemia: the Eastern Cooperative Oncology Group experience.
Blood.
2000;96:2405-2411[Abstract/Free Full Text].
Response:
Diagnosis of acute megakaryocytic leukemia
We appreciate the comment from Dr Strauchen, since a strict
interpretation of the percent blasts being less than 30% for the 6 patients he mentions is correct. But in all of these cases, there was a
significant percentage of circulating blasts, ranging from 7% to 63%,
and there was considerable marrow fibrosis that prevented doing a
precise marrow blast count. In case 12, the high platelet count, severe
marrow fibrosis, and dysplastic megakaryocytes permitted the diagnosis
to be established.1 An additional reference that provides
more insight into the diagnosis of the acute myeloid leukemia is Cheson
et al.2
Martin S. Tallman
Robert H. Lurie Comprehensive Cancer Center Northwestern
University Medical School Chicago, Illinois
John M. Bennett
University of Rochester Cancer Center Rochester, New York
References
1.
Tallman MS, Neuberg D, Bennett JM, et al.
Acute megakaryocytic leukemia: the Eastern Cooperative Oncology Group experience.
Blood.
2000;96:2405-2411.
2.
Cheson BD, Cassileth PA, et al.
Report of the NCI Sponsored Workshop on the Definitions of Diagnosis and Response in Acute Myeloid Leukemia.
J Clin Oncol.
1990;8:813-819[Abstract].
