Correlation between abnormal localization of immature precursors like structure and early relapse in patients with acute myeloid leukemia

Objective To investigate the correlation between abnormal localization of immature precursors (ALIP)-like structure in bone marrow biopsy and early relapse of acute myeloid leukemia (AML).Methods Computer image processing technology was performed to detect of the distance between precursors and endosteum,and density of precursors was also calculated under light microscopic image.Clinical data of 40 AML patients with complete remission (CR) were analyzed.Results Beside single and double precursors,there were also clustered precursors of 3-5 cells during CR.Clustered precursors,but not single and double precursors,was a risk factor of relapse.Early relapse was detected with a sensitivity of 51.5 ％ and a specificity of 85.7 ％ using a standard cut-off value of ＞4.0/mm2 for cluster density.Conclusions Clustered precursors in bone marrow sections during CR may be an independent risk factor of early relapse.Cluster density ＞ 4.0/mm2 may indicate poor prognosis in AML patients and early aggressive interventions are needed to prevent hematologic relapse. Key words: Leukemia, myelocytic, acute;  Bone marrow biopsy;  ALIP-like structure;  Early relapse