Clinicopathologic Characterization of Hypocellular Acute Myeloid Leukemia (AML) Showed Fewer Genetic Abnormalities Involving Cell Proliferation and NPM1 When Compared With Nonhypocellular AML.

OBJECTIVES: Hypocellular acute myeloid leukemia (AML) is uncommon. Despite the prognostic and therapeutic importance of mutational analysis, the mutational landscape of hypocellular AML is not well understood. METHODS: We identified 25 patients with hypocellular AML, and 141 patients with nonhypocellular AML were identified as a control group. We applied next-generation sequencing for the first time to profile this entity. RESULTS: The hypocellular AML patients were older than those with nonhypocellular AML (P = .037). At diagnosis, hypocellular AML had lower leukocyte counts (P = .012), higher hemoglobin (P = .003), and lower blast counts in the peripheral blood (P < .001) and bone marrow (P = .003). Hypocellular AML was less likely to have mutations involving cell proliferation (P = .027) and NPM1 (P = .022) compared with nonhypocellular AML. Hypocellular AML showed a high incidence of spliceosomal mutations and myelodysplastic syndrome-defining chromosome abnormalities (65%), but the incidence was not significantly different from that in nonhypocellular AML. There was no significant survival difference between hypocellular and nonhypocellular AML. CONCLUSIONS: To our knowledge, this study is the first to demonstrate hypocellular AML showed fewer genetic alterations involving cell proliferation and NPM1 when compared directly with nonhypocellular AML; this finding likely contributes to the low marrow cellularity in at least a portion of the patients with hypocellular AML.

Emotion regulation, affect, psychosocial functioning, and well-being in hemodialysis patients.

BACKGROUND: Emotion regulation refers to the psychological strategies people use to cope with such stressors as hemodialysis therapy. These strategies are associated with a range of physical and psychological variation that may be related to kidney disease and its management. This study explores the associations of 2 emotion regulation strategies, reappraisal and suppression, and considers their impact on patient well-being and kidney disease management. STUDY DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: 106 hemodialysis patients undergoing renal replacement therapy and 94 friends or relatives. PREDICTORS: Reappraisal and suppression, measured by using the Emotion Regulation Questionnaire. OUTCOMES: Outcome parameters were measures of affect, psychosocial functioning, and well-being, measured using the Positive and Negative Affect Scale, the Brief COPE questionnaire, the Kidney Disease Quality-of-Life Short Form, and the Brief Symptom Inventory. RESULTS: The Emotion Regulation Questionnaire measured reappraisal and suppression. Greater use of reappraisal was associated with lower levels of anxiety (r = -0.22; P = 0.03) and greater acceptance of the disease (r = 0.20; P = 0.04). It was also associated with more experience (r = 0.26; P < 0.01) and expression (r = 0.23; P = 0.02) of positive emotion and less experience (r = -0.35; P < 0.01) and expression (r = -0.29; P < 0.01) of negative emotion. Suppression was associated with less positive emotional expression (r = -0.28; P < 0.01), greater levels of depression (r = 0.22; P = 0.03) and somatization (r = 0.25; P < 0.01), and greater dissatisfaction with the time spent dealing with their kidney disease (r = -0.21; P = 0.04). Suppression also was associated with less emotional coping (r = -0.29; P < 0.01) and greater dissatisfaction with the support received from other people (r = -0.34; P < 0.01). LIMITATIONS: The study focuses on emotion regulation strategies and well-being rather than clinical parameters; therefore, extensive medical data were not recorded. CONCLUSION: Reappraisal has more positive clinical and psychosocial associations than suppression. The emotion regulation strategy used by hemodialysis patients has important implications for well-being and disease management.