{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:04:24Z","timestamp":1790269464703,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,1,22]],"date-time":"2016-01-22T00:00:00Z","timestamp":1453420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The MD Anderson Cancer Center Support Grant (CCSG)","award":["CA01667"],"award-info":[{"award-number":["CA01667"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:p>Acute myeloid leukemia (AML) is defined as \u226520% myeloblasts, representing a change from original guidelines where \u226430% blasts were considered as myelodysplastic syndromes (MDS), and 20\u201329% blasts classified as refractory anemia with excess blasts in transformation (RAEB\u2010T). Whether the diagnostic bone marrow blast percentage has current value with regards to patient prognostication or identification of optimal treatment strategies is unclear. We retrospectively studied 1652 treatment\u2010na\u00efve adults with MDS or AML and \u226510% blasts from January 2000 to April 2014. Patients with 20\u201329% blasts were more similar to MDS patients in terms of advanced age, increased frequency of poor\u2010risk cytogenetics, lower WBC count, and less frequent <jats:italic>NPM1<\/jats:italic> and <jats:italic>FLT3\u2010ITD<\/jats:italic> mutations. Median overall survival of MDS and RAEB\u2010T were similar, 16.0 and 16.0 months, compared to 13.5 months for AML with \u226530% blasts (<jats:italic>P<\/jats:italic>\u2009=\u20090.045). Multivariate analysis showed inferior survival with increased age (HR 1.81 age 60\u201369, HR 2.68 age \u226570, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0005); poor\u2010risk cytogenetics (HR 2.25, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0005); therapy\u2010related disease (HR 1.44, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0005); and markers of proliferative disease including WBC \u226525 \u00d7 10<jats:sup>9<\/jats:sup>\/L (HR 1.35, <jats:italic>P =<\/jats:italic> 0.0003), elevated LDH count (HR 1.24, <jats:italic>P<\/jats:italic>\u2009=\u20090.0015), and peripheral blasts (HR 1.25, <jats:italic>P<\/jats:italic>\u2009=\u20090.004). Among younger patients (\u226460 years), intensive AML\u2010type therapy resulted in similar outcomes regardless of blast percentage, suggesting this to be optimal therapy in this context. Among older patients (\u226570 years), patients with 20\u201329% blasts had similar outcomes to patients with &lt;20% blasts, and better than those with \u226530% blasts. In addition, among older patients, epigenetic therapy provided at least equivalent outcome to intensive chemotherapy. Am. J. Hematol. 91:227\u2013232, 2016. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.24252","type":"journal-article","created":{"date-parts":[[2015,11,24]],"date-time":"2015-11-24T09:34:53Z","timestamp":1448357693000},"page":"227-232","source":"Crossref","is-referenced-by-count":57,"title":["Interactions and relevance of blast percentage and treatment strategy among younger and older patients with acute myeloid leukemia (<scp>AML<\/scp>) and myelodysplastic syndrome (<scp>MDS<\/scp>)"],"prefix":"10.1002","volume":"91","author":[{"given":"Courtney D.","family":"DiNardo","sequence":"first","affiliation":[{"name":"Department of Leukemia University of Texas M.D. Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Garcia\u2010Manero","sequence":"additional","affiliation":[{"name":"Department of Leukemia University of Texas M.D. Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Pierce","sequence":"additional","affiliation":[{"name":"Department of Leukemia University of Texas M.D. Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aziz","family":"Nazha","sequence":"additional","affiliation":[{"name":"Department of Hematologic Oncology and Blood Disorders Cleveland Clinic Taussig Cancer Institute Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Bueso\u2010Ramos","sequence":"additional","affiliation":[{"name":"Department of Hematopathology University of Texas M.D. Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Leukemia University of Texas M.D. Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Ravandi","sequence":"additional","affiliation":[{"name":"Department of Leukemia University of Texas M.D. Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Cortes","sequence":"additional","affiliation":[{"name":"Department of Leukemia University of Texas M.D. Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagop","family":"Kantarjian","sequence":"additional","affiliation":[{"name":"Department of Leukemia University of Texas M.D. Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,1,22]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1976.tb03563.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V89.6.2079"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-03-420489"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-04-1199"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.9.2486"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V90.8.2969"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69780-8"},{"key":"e_1_2_5_9_1","first-page":"1400","article-title":"The incidence and outcome of myeloid malignancies in 2,112 adult patients in southeast England","volume":"91","author":"Phekoo KJ","year":"2006","journal-title":"Haematologica"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28129"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-09-179341"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21723"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-09-3724"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0b013e328358f62d"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-04-014324"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-07-235358"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-08-375758"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23697"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-10-4149"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.04.036"},{"key":"e_1_2_5_21_1","unstructured":"Myelodysplastic syndromes. NCCN Clinical Practice Guidelines on Oncology [Internet].2011."},{"key":"e_1_2_5_22_1","first-page":"2541","article-title":"High p53 protein expression in therapy\u2010related myeloid neoplasms is associated with adverse karyotype and poor outcome","author":"Cleven AH","year":"2014","journal-title":"Mod Pathol"},{"key":"e_1_2_5_23_1","article-title":"Role of TP53 mutations in the origin and evolution of therapy\u2010related acute myeloid leukaemia","author":"Wong TN","year":"2014","journal-title":"Nature"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-05-283648"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2004.00225.x"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-01-267302"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.24252","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.24252","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T12:43:04Z","timestamp":1695472984000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.24252"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,22]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1002\/ajh.24252"],"URL":"https:\/\/doi.org\/10.1002\/ajh.24252","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,22]]}}}