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Distinct subsets can be identified using GEP that correspond to known cytogenetic and molecular abnormalities.
Patients with leukemias that express the progenitor cell antigen CD34 and/or the P-glycoprotein ( Cytogenetic analysis provides some of the strongest prognostic information available, predicting outcome of both remission induction and postremission therapy, as seen in a trial from the Southwest Oncology Group (SWOG) and the Eastern Cooperative Oncology Group (ECOG) (E-3489). Cytogenetic abnormalities that indicate a good prognosis include t(8; 21), inv(16) or t(16;16), and t(15;17). Patients with AML that is characterized by deletions of the long arms or monosomies of chromosomes 5 or 7; by translocations or inversions of chromosome 3, t(6; 9), t(9; 22); or by abnormalities of chromosome 11q23 have particularly poor prognoses with chemotherapy.Data suggest that once attained, duration of remission may be shorter in older patients.Increased morbidity and mortality during induction appear to be directly related to age.AML with t(8; 21)(q22; q22); (AML/) AML with the translocation t(8; 21)(q22; q22) (occurring most commonly in FAB classification M2) is one of the most common genetic aberrations in AML and accounts for 5% to 12% of cases of AML and 33% of karyotypically abnormal cases of acute myeloblastic leukemia with maturation. Myeloid sarcomas (chloromas) may be present and may be associated with a bone marrow blast percentage of less than 20%.Common morphologic features include the following: AML with maturation (FAB classification M2) is the most common morphologic type correlating with t(8; 21).