British Journal of Haematology

June 2009

Bacher U, Kohlmann A, Haferlach T. Current status of gene expression profiling in the diagnosis and management of acute leukaemia. Br J Haematol 2009;145:555–68.

The French-American-British (FAB) classification groups leukaemias according to their morphological appearance and was refined by cytogenetic analysis by the World Health Organization (WHO). However there can be great variation in outcome between leukaemias of the same subtype. Gene expression profiling is a powerful tool that has validated the FAB and WHO classifications of acute myeloid leukaemia. In addition, this technology risk stratifies patients with the same leukaemia, may be used to tailor treatments to individual patients and may identify potential new targets for treatment. Gene expression profiling will be introduced into clinical practice. This review provides a grasp of its progress so far, and the necessary directions for future development.

Wheatley K, Brookes CL, Howman AJ, et al. Prognostic factor analysis of the survival of elderly patients with AML in the MRC AML11 and LRF AML14 trials. Br J Haematol 2009;145:598–605.

Acute myeloid leukaemia (AML) carries a poor prognosis in patients over 60 years of age, whether they are treated with intensive or non-intensive chemotherapies. The risks of intensive chemotherapy often outweigh the potential benefits. The dilemma for the clinician is in deciding how aggressive to be in pursuit of remission. This study proposes an equation, constructed from results of the Medical Research Council (MRC) AML11 trial and validated in the Leukaemia Research Fund (LRF) AML14 and AML14NI trials. Risk scores are dependent on cytogenetic group, white cell count, age, type of leukaemia and performance status. Patients are then stratified into low, intermediate and high risk groups.

Lonial S, Cavenagh J. Emerging combination treatment strategies containing novel agents in newly diagnosed multiple myeloma. Br J Haematol 2009;145:681–708.

After years of …