Table 1 The main morphological, clinical, cytogenetic and molecular genetic characteristics, and treatment options, in the major myeloid malignancies
Characteristics/treatment options | CML | CMML | APL | AML |
|---|---|---|---|---|
Morphological characteristics | Proliferation of mature granulocytes and precursors | Proliferation of monocytes, also dysplasia in other cell lineages | Accumulation of promyelocytes | Accumulation of immature myeloid cells |
Clinical characteristics | Mild symptoms (malaise, low fever), often asymptomatic; slow progression of disease | Bone marrow failure; often general symptoms: weight loss, night sweats | Often severe bone marrow failure (anemia, infection, bleeding) often coagulopathy; aggressive disease | Often severe bone marrow failure (anemia, infection, bleeding); aggressive disease |
Cytogenetic characteristics | Reciprocal translocation between chromosomes 9 and 22 t(9;22) | Several described; could also be normal (60% to 70%) | Balances reciprocal translocation between chromosomes 15 and 17 t(15;17) | Several described; could also be normal (45%) |
Molecular genetic characteristics | Probably important in disease development and resistance to TKIs | Several described; RAS family (N-RAS/K-RAS) seems of special interest | None recognized | Several discovered (Table 2), important in risk stratification |
Main treatment options | First- and second-generation TKIs, allo-SCT | Chemotherapeutics, 5-azacitidine, allo-SCT | ATRA, arsenic trioxide, chemotherapeutics, allo-SCT | Chemotherapeutics, allo-SCT |