Prognostic significance of auer rods in childhood acute myelogenous leukemia: Results of the studies AML‐BFM‐78 and −83

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Abstract
The prognostic significance of Auer rods in predicting response rate and remission duration was investigated in 257 patients of the two West German acute myelogenous leukemia (AML) studies BFM‐78 and ‐83. Auer rods were found in 129 children (50%) in the initial bone marrow smear. The incidence was higher in myeloid subtypes M1 (63%) and M2 (78%) compared with subtypes M4 (47%) and M5 (5%) with monocytic differentiation. In both studies, the remission rate was significantly higher in patients with Auer rods (P= 0.01), and in the study AML‐BFM‐83 a significantly longer remission duration was evaluated for Auer rodpositive patients (P= 0.007). In the M1 type, Auer rods were of high prognostic significance regarding both the induction success (P= 0.003) and the remission duration (P= 0.004), whereas no significant differences between Auer rodpositive and ‐negative patients in other subtypes were found. Occurrence of Auer rods was independent of hyperleukocytosis, the most powerful prognostic parameter in the studies AML‐BFM‐78 and ‐83, whereas absence of Auer rods was associated with the AML risk group M5. In the M1 type, Auer rod‐negative leukemias appeared to represent cases of poorly differentiated AML. Auer rods were therefore useful in differentiating between patients with a poor and a more favorable prognosis, particularly in the M1 type.