Acute myeloid leukemia
Acute myeloid leukemias with multilinear dysplasia in residual normal sprouts of hemopoiesis are distinguished on the basis of certain morphological features, the presence of which sometimes makes it difficult to diagnose a specific variant of acute leukemia. In accordance with recent views in the classification indicates that the presence of multilinear dysplasia is a poor prognostic sign. A number of authors, including us, have shown that the presence of dysplasia does not in itself have a negative prognostic value, and a poor prognosis is determined by the frequent presence of unfavorable chromosomal aberrations in patients of this group. Most likely, this rubric will disappear from the classification in the future.
Rationally, in our opinion, the selection in a separate section of acute myeloid leukemia and myelodysplastic syndromes, the development of which can be associated with previous therapy, mainly with the use of alkylating drugs, topoisomerase II inhibitors and radiation therapy. These leukemias also have fairly well-defined biological features — often a period of myelodysplasia preceding the development of leukemia, often with characteristic or multiple chromosomal aberrations, often worse than de novo response to therapy and prognosis. In this group, in each case, when making a diagnosis, the notation is used in accordance with the FAB classification.
If acute myeloid leukemias do not belong to any of the listed groups, they are characterized in accordance with the FAB classification. It should be noted that in practice the classification of FAB is always used, and this must be recognized as rational, as it allows you to accurately determine which variant of acute myeloid leukemia is involved, and thus avoid erroneous conclusions in assessing the results obtained by different authors.