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  • 1.
    Billstrom, R.
    et al.
    Billström, R., Department of Hematology, Lund University Hospital, Lund, Sweden, Department of Hematology, University Hospital, SE-221 85 Lund, Sweden.
    Ahlgren, T.
    Department of Hematology, Malmö University Hospital, Malmö, Sweden.
    Bekassy, A.N.
    Békássy, A.N., Department of Pediatrics, Lund University Hospital, Lund, Sweden.
    Malm, C.
    Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Haematology.
    Olofsson, T.
    Department of Hematology, Lund University Hospital, Lund, Sweden.
    Hoglund, M.
    Höglund, M., Department of Clinical Genetics, Lund University Hospital, Lund, Sweden.
    Mitelman, F.
    Department of Clinical Genetics, Lund University Hospital, Lund, Sweden.
    Johansson, B.
    Department of Clinical Genetics, Lund University Hospital, Lund, Sweden.
    Acute myeloid leukemia with inv(16)(p13q22): Involvement of cervical lymph nodes and tonsils is common and may be a negative prognostic sign2002In: American Journal of Hematology, ISSN 0361-8609, E-ISSN 1096-8652, Vol. 71, no 1, p. 15-19Article in journal (Refereed)
    Abstract [en]

    Acute myeloid leukemia (AML) with inv(16)(p13q22) or the variant t(16,16)(p13,q22), is strongly associated with the FAB subtype M4Eo. A high incidence of CNS involvement was reported in the 1980s, but otherwise little is known about the pattern of extamedullary leukemia (EML) manifestations in this AML type. We have compiled clinical and cytogenetic data on 27 consecutive AML cases with inv(16)/t(16,16) from southern Sweden. In general, these AMLs displayed the clinical features that have previously been described as characteristic for this disease entity: low median age, hyperleukocytosis, M4Eo morphology, and a favorable prognosis. However, CNS leukemia was only seen in relapse in one patient diagnosed in 1980, whereas the most common EML manifestation in our series was lymphadenopathy (5/27, 19%), most often cervical with or without gross tonsillar enlargement. A review of previously published, clinically informative cases corroborates that lymphadenopathy, with preference for the cervical region, is the most common EML at diagnosis in inv(16)-positive AML (58/175, 33%). CNS leukemia, on the other hand, has been reported in only 17% of the cases, mostly in the relapse setting, with a diminishing frequency over time, possibly due to protective effects of high-dose cytarabine. Other reported EML sites include the scalp, ovaries, and the intestine. Cervicotonsillar EML was in our series associated with a shorter duration of first remission, (P< 0.05), and may hence prove to be an important clinical parameter when deciding treatment strategies in AML with inv(16)/t(16,16). © 2002 Wiley-Liss, Inc.

  • 2.
    Hulegardh, Erik
    et al.
    Sahlgrens University Hospital, Sweden; Sahlgrens University Hospital, Sweden.
    Nilsson, Christer
    Karolinska University Hospital, Sweden.
    Lazarevic, Vladimir
    Swedish Acute Myeloid Leukemia Grp; Skåne University Hospital, Sweden; Skåne University Hospital, Sweden; Lund University, Sweden.
    Garelius, Hege
    Swedish Acute Myeloid Leukemia Grp; Sahlgrens University Hospital, Sweden; Sahlgrens University Hospital, Sweden.
    Antunovic, Petar
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Swedish Acute Myeloid Leukemia Grp.
    Rangert Derolf, Asa
    Swedish Acute Myeloid Leukemia Grp; Karolinska University Hospital, Sweden; Karolinska University Hospital, Sweden.
    Mollgard, Lars
    Swedish Acute Myeloid Leukemia Grp; Sahlgrens University Hospital, Sweden; Sahlgrens University Hospital, Sweden.
    Uggla, Bertil
    Swedish Acute Myeloid Leukemia Grp; Örebro University Hospital, Sweden.
    Wennstrom, Lovisa
    Swedish Acute Myeloid Leukemia Grp; Sahlgrens University Hospital, Sweden; Sahlgrens University Hospital, Sweden.
    Wahlin, Anders
    Swedish Acute Myeloid Leukemia Grp; Umeå University, Sweden; Norrland University Hospital, Sweden.
    Hoglund, Martin
    Swedish Acute Myeloid Leukemia Grp; Academic Hospital, Sweden; Academic Hospital, Sweden.
    Juliusson, Gunnar
    Skåne University Hospital, Sweden; Skåne University Hospital, Sweden; Lund University, Sweden;Swedish Acute Myeloid Leukemia Grp.
    Stockelberg, Dick
    Swedish Acute Myeloid Leukemia Grp; Sahlgrens University Hospital, Sweden; Sahlgrens University Hospital, Sweden.
    Lehmann, Soren
    Swedish Acute Myeloid Leukemia Grp; Karolinska University Hospital, Sweden.
    Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: A report from the Swedish Acute Leukemia Registry2015In: American Journal of Hematology, ISSN 0361-8609, E-ISSN 1096-8652, Vol. 90, no 3, p. 208-214Article in journal (Refereed)
    Abstract [en]

    Patients with secondary acute myeloid leukemia (AML) often escape inclusion in clinical trials and thus, population-based studies are crucial for its accurate characterization. In this first large population-based study on secondary AML, we studied AML with an antecedent hematological disease (AHD-AML) or therapy-related AML (t-AML) in the population-based Swedish Acute Leukemia Registry. The study included 3,363 adult patients of which 2,474 (73.6%) had de novo AML, 630 (18.7%) AHD-AML, and 259 (7.7%) t-AML. Secondary AML differed significantly compared to de novo AML with respect to age, gender, and cytogenetic risk. Complete remission (CR) rates were significantly lower but early death rates similar in secondary AML. In a multivariable analysis, AHD-AML (HR 1.51; 95% CI 1.26-1.79) and t-AML (1.72; 1.38-2.15) were independent risk factors for poor survival. The negative impact of AHD-AML and t-AML on survival was highly age dependent with a considerable impact in younger patients, but without independent prognostic value in the elderly. Although patients with secondary leukemia did poorly with intensive treatment, early death rates and survival were significantly worse with palliative treatment. We conclude that secondary AML in a population-based setting has a striking impact on survival in younger AML patients, whereas it lacks prognostic value among the elderly patients.

  • 3.
    Jakobsen Falk, Ingrid
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences.
    Fyrberg, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences.
    Paul, Esbjörn
    Karolinska Institutet, Stockholm, Sweden.
    Nahi, Hareth
    Karolinska Institutet, Stockholm, Sweden.
    Hermanson, Monica
    Uppsala University, Sweden.
    Rosenquist, Richard
    Uppsala University, Sweden.
    Höglund, Martin
    University of Gothenburg, Sweden.
    Palmqvist, Lars
    University of Gothenburg, Sweden.
    Stockelberg, Dick
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Wei, Yuan
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Gréen, Henrik
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences.
    Lotfi, Kourosh
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pharmacology.
    Decreased survival in normal karyotype AML with single-nucleotide polymorphisms in genes encoding the AraC metabolizing enzymes cytidine deaminase and 5'-nucleotidase2013In: American Journal of Hematology, ISSN 0361-8609, E-ISSN 1096-8652, Vol. 88, no 12, p. 1001-1006Article in journal (Refereed)
    Abstract [en]

    De novo acute myeloid leukemia with normal karyotype (NK-AML) comprises a large group of patients with no common cytogenetic alterations and with a large variation in treatment response. Single-nucleotide polymorphisms (SNPs) in genes related to the metabolism of the nucleoside analogue AraC, the backbone in AML treatment, might affect drug sensitivity and treatment outcome. Therefore, SNPs may serve as prognostic biomarkers aiding clinicians in individualized treatment decisions, with the aim of improving patient outcomes. We analyzed polymorphisms in genes encoding cytidine deaminase (CDA 79A>C rs2072671 and −451C>T rs532545), 5′-nucleotidase (cN-II 7A>G rs10883841), and deoxycytidine kinase (DCK 3′UTR 948T>C rs4643786) in 205 de novo NK-AML patients. In FLT3-internal tandem duplication (ITD)-positive patients, the CDA 79C/C and −451T/T genotypes were associated with shorter overall survival compared to other genotypes (5 vs. 24 months, P < 0.001 and 5 vs. 23 months, P = 0.015, respectively), and this was most pronounced in FLT3-ITD-positive/NPM1-positive patients. We observed altered in vitro sensitivity to topoisomerase inhibitory drugs, but not to nucleoside analogues, and a decrease in global DNA methylation in cells carrying both CDA variant alleles. A shorter survival was also observed for the cN-II variant allele, but only in FLT3-ITD-negative patients (25 vs. 31 months, P = 0.075). Our results indicate that polymorphisms in genes related to nucleoside analog drug metabolism may serve as prognostic markers in de novo NK-AML

  • 4.
    Lazarevic, V.L.
    et al.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Remberger, M.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Hagglund, H.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Hallbook, H.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Juliusson, G.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Kimby, E.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Malm, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Oncology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology UHL.
    Wahlin, A.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Omar, H.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Johansson, J.-E.
    Department of Hematology, University Hospital Lund, Lund University, Lund, Sweden.
    Letter: Myeloablative allogeneic stem cell transplantation for lymphoblastic lymphoma in Sweden: A retrospective study2011In: American Journal of Hematology, ISSN 0361-8609, E-ISSN 1096-8652, Vol. 86, no 8, p. 709-710Article in journal (Other academic)
    Abstract [en]

    [No abstract available]

  • 5.
    Lazarevic, Vladimir
    et al.
    Skåne University Hospital, Sweden; Lund University, Sweden.
    Rosso, Aldana
    Skåne University Hospital, Sweden.
    Juliusson, Gunnar
    Skåne University Hospital, Sweden; Lund University, Sweden.
    Antunovic, Petar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Haematology. Linköping University, Faculty of Medicine and Health Sciences.
    Rangert-Derolf, Asa
    Karolinska University Hospital, Sweden.
    Lehmann, Soren
    Karolinska University Hospital, Sweden.
    Mollgard, Lars
    Sahlgrens University Hospital, Sweden.
    Uggla, Bertil
    Örebro University Hospital, Sweden.
    Wennstrom, Lovisa
    Sahlgrens University Hospital, Sweden.
    Wahlin, Anders
    Umeå University, Sweden.
    Hoglund, Martin
    Academic Hospital, Sweden.
    Johansson, Bertil
    University of and Regional Labs Regional Skåne, Sweden; Lund University, Sweden.
    Prognostic significance of high hyperdiploid and triploid/tetraploid adult acute myeloid leukemia2015In: American Journal of Hematology, ISSN 0361-8609, E-ISSN 1096-8652, Vol. 90, no 9, p. 800-805Article in journal (Refereed)
    Abstract [en]

    To ascertain the clinical implications of high hyperdiploid (HH; 49-65 chromosomes) and triploid/tetraploid (TT; greater than65 chromosomes) adult acute myeloid leukemia (AML), all such cases were retrieved from the Swedish AML Registry. Of the 3,654 cytogenetically informative cases diagnosed between January 1997 and May 2014, 68 (1.9%) were HH (n=50)/TT (n=18). Patients with HH/TT were older than those with intermediate risk (IR) AML (median 71 years vs. 67 years; P=0.042) and less often had de novo AML (63% vs. 79%; P=0.004); no such differences were observed between HH/TT and complex karyotype (CK) AML. The overall survival (OS) was similar between patients with HH/TT and CK AML (median 0.9 years vs. 0.6 years; P=0.082), whereas OS was significantly longer (median 1.6 years; P=0.028) for IR AML. The OS was shorter for cases with HH than with TT (median 0.6 years vs. 1.4 years; P=0.032) and for HH/TT AMLs with adverse abnormalities (median 0.8 years vs. 1.1 years; P=0.044). In conclusion, HH/TT AML is associated with a poor outcome, but chromosome numbers greater than65 and absence of adverse aberrations seem to translate into a more favorable prognosis. Thus, HH/TT AMLs are clinically heterogeneous and should not automatically be grouped as high risk.Am. J. Hematol. 90:800-805, 2015. (c) 2015 Wiley Periodicals, Inc.

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