Acute Myeloid Leukemia with Myelodysplasia Related Changes

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Motoharu Shibusawa, MD
Tetsuya Tanimoto, MD


Acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) is one of the common subtypes of AML. It accounts for approximately 20% of newly diagnosed AML. The World Health Organization classification 2017 defines AML-MRC as acute leukemia with ≥20% blasts in the peripheral blood or bone marrow with morphological features of myelodysplasia, or occurring in patients with a prior history of myelodysplastic syndrome (MDS) or myelodysplastic/myeloproliferative neoplasm (MDS/MPN), with MDS related cytogenetic abnormalities, and the absence of specific genetic abnormalities of AML with recurrent genetic abnormalities. In diagnosing AML-MRC, there are three main criteria; the presence of (i) dysplasia; (ii) chromosomal abnormalities associated with AML-MRC; and (iii) a prior history of MDS or MDS/MPN. Therefore, AML-MRC is a heterogeneous disease, and the prognosis of each AML-MRC varies widely. AML-MRC is usually treated with chemotherapy, and hematopoietic stem cell transplantation is one of the treatment options. Prognostic factors should be considered in planning a treatment strategy for each case.


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Chapter 6