FREQUENCY OF FAB SUBTYPES IN ACUTE MYELOID LEUKEMIA PATIENTS AT AGA KHAN UNIVERSITY HOSPITAL KARACHI

Authors

  • Mahadev S. Harani
  • Salman Naseem Adil
  • Mohammad Usman Shaikh
  • Ghulam Nabi Kakepoto
  • Mohammmad Khurshid

Abstract

Background: Acute myeloid leukemia (AML) is a heterogeneous disease. Therefore, various parameters are needed to classify this disease into subtypes, so that specific treatment approaches can be utilized effectively. The commonly used method for diagnosis and classification is based on FAB criteria using morphology and cytochemical stains. For some of the categories, immunophenotyping is necessary. The aim of present study is to determine the frequency of various sub types in acute myeloid leukemia using FAB criteria in our population. This will aid in the correct diagnosis of acute leukemia and hence proper management of the patients. Materials and Methods: This is descriptive case control study conducted at Aga Khan University Hospital from January 1999 to December 2000. The total number of subjects was 116 that included both adults and children. The patients were diagnosed on the basis of bone marrow morphology using FAB classification. Cytochemistry was done in all cases, while immunophenotyping was considered only in those cases that were found to be problematic. Results: Among 116 patients, 70 were males and 46 were females with male to female ratio 1.5:1. The age ranged between 6 months to 85 years with a mean age of 32 years. AML-M4 was the predominant French-American-British (FAB) subtype (36.2%) followed by M2 (30.25%), M3 (10.4%), M1 (8.7%), M0 (7.7%), M5a (3.5%), M5b (2.5%) and M6 (0.8%). Conclusions: The most common FAB subtype observed in our study was Acute myelomonocytic leukemia (M4) which is in accordance with studies reported from Saudia Arabia and a previous study reported from our institution. However,other national and international studies have reported Myeloblastic Leukemia with maturation (M2) as the predominant subtype of AML.Keywords: French-American-British (FAB) classification, Acute myeloid Leukemia (AML), subtypes. 

References

Tien HF, Wang CH, Lin MT, Lee FY, Liu MC, Chuang SM, et al. Correlation of cytogenetic results with immunophenotype, genotype, chemical features and ras mutation in acute myeloid leukemia: a study of 235 Chinese patients in Taiwan. Cancer Genet Cytogenet 1995;84:60-8.

Schoch C, Haferlach T. Cytogenetics in acute myeloid leukemia. Curr Oncol Rep 2002;4:390-7.

Browman GP, Naeme PB, Soamboonsrup P. The contribution of cytochemistry and immunophenotyping to the reproducibility of the FAB classification in acute leukemia. Blood 1986;68:900-5

Benett JM, Catovsky D, Daniel MT Flandrin G, Galton DA, Gralnick HR, et al. Proposals for the classification of acute leukemias. Br J Haematol 1976;33:451-8.

Bennett JM, Catovsky D, Dariel MT Flandrin G, Galton DA, Gralnick HR, et al. Proposed revised criteria for the classification of acute myeloid leukemia: a report of FAB Cooperative Group. Ann Intern Med 1985:103;626-9.

Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, et al. Criteria for the diagnosis of acute leukemia of megakaryocytic lineage (M7). A report of the French-American-British cooperative Group. Ann Intern Med 1985;103;460-2

Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, et al. Proposal for the recognition of minimally differentiated acute myeloid leukemia (AML-MO). Br J Haematol 1991;78:325-9.

McKenna RW. Multifaceted approach to the diagnosis and classification of acute leukemias. Clin Chem 2000;46:1252-9

Arber DA, Stein AS, Carter NH, Ikle D, Formen SJ, Slovak ML. Prognostic impact of acute myeloid leukemia classification. Importance of detection of recurring cytogenetic abnormalities and multilineage dysplasia on survival. Am J Clin Pathol 2003;119:672-80.

Head DR. Revised classification of acute myeloid leukemia. Leukemia 1996;10:1826-31.

Harris NL, Jaffe ES, Diebold J,Flandrin G, Muller-Hermelink HK,Vardiman J, et al. World Health Organization classification of neoplastic diseases of hematopoietic and lymphoid tissue. Report of the clinical advisory committee meeting Airlie House, Virginia, November 1997.J Clin Oncol 1999;17:3835-49. .

Swirsky DM, de Bastos M, Parish SE, Rees JK, Hayhoe FG. Features affecting outcome during remission induction of acute myeloid leukaemia in 619 adult patients. Br J Haematol 1986;64:435-53.

Spence DG, Roberts GT, De Vol EB, Clink HM, Andrew Padmos M. Acute myeloid leukemia in Saudia Arabia: Morphologic classification using FAB subgroups. Ann Saudi Med 1988;8:179-84

Raina V, El-Habbash KI, Tenkovsky. Acute nonlymphoblastic leukemia in adults: experience in Tripoli Libya. Ann Saudi Med 1990;10:299-302

Hassan K, Qureshi M, Shafi S, Ikram N, Akhtar MJ. Acute myeloid leukaemia- FAB classification and its correlation with clinico- heamatological features. J Pak Med Assoc 1993; 43:200-3

Chaudhry MT, Tayyab M, Faooqi IA.Acute nonlymphoblastic leukemia in adults. J Pak Med Assoc 1993; 43:259-61

Harakati MSE, Al-Momen AM, Ajarim DS, Al-Moharib FI, Al- Theyab A, Fawzy EM, et al. Adult acute myeloblastic leukemia: Experience at King Khalid University Hospital. Ann Saudi Med 1998;18:221-5

Khalidi HS, Medeiros LJ, Chang KL, Brynes RK, Solvak ML, Arber DA. The immunophenotye of adult acute myeloid leukemia: high frequency of lymphoid antigen expression and comparison of immunophenotype, French-American-British classification, and karyotypic abnormalities. Am J Clin Pathol 1998;109:211-20.

Kakepoto GN, Burney IA, Zaki S, Adil SN, Khurshid M. Long-term outcomes of acute myeloid leukemia in adults in Pakistan. J Pak Med Assoc 2002; 52: 482-6

Pagano L, Pulsoni A, Tosti ME, Avvisati G, Mele L, Mele A, et al. Clinical and biological features of acute myeloid leukemia occurring as second malignancy: GIMEMA archive of adult acute leukemia. Br J Haematol 2001; 112:109-17.

Nakase K, Bradstock K, Sartor M, Gottlieb D, Byth K, Kita K, et al. Geographic heterogeneity of cellular characteristics of acute myeloid leukemia: a comparative study of Australian and Japanese adult cases. Leukemia 2000; 14: 163-8.

Sultan C, Deregnaucort J, Ko YW, Imbert M, D'Agay MF, Gouault-Heilman M, et al. Distribution of 250 cases of acute myeloid leukemia (AML) according to the FAB classification and response to therapy. Br J Haematol 1981; 47: 545-51

Mauritzen N, Johansson B, Albin M, Billström R, Ahfgren T, Mikoczy Z, et al. A single center population-based consecutive series of 1500 cytogenetically investigated adult hematological malignancies: Karyotype features in relation to morphology, age and gender. Eur J Haematol 1999; 62: 92-102.

Khalid A, Zahid M, Rehman A, Ahmad Z U, Qazi S, Aziz Z. Clinico- epidemiological features of adult leukemias in Pakistan. J Pak Med Assoc 1997; 47:119-22.

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Harani, M. S., Adil, S. N., Shaikh, M. U., Kakepoto, G. N., & Khurshid, M. (2005). FREQUENCY OF FAB SUBTYPES IN ACUTE MYELOID LEUKEMIA PATIENTS AT AGA KHAN UNIVERSITY HOSPITAL KARACHI. Journal of Ayub Medical College Abbottabad, 17(1). Retrieved from https://jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/4112