title: The prognostic significance of rapid peripheral blood blast clearance during the initial course of induction chemotherapy in young patients with de novo acute myeloid leukemia.
abstract: The early clearance of blast cells in peripheral blood (PB) during induction chemotherapy can predict the clinical outcome in acute leukemia. We retrospectively analyzed the kinetics of white blood cell (WBC) count, blast cell percentage (BCP), and blast cell count (BCC) in PB in 78 patients with de novo acute myeloid leukemia who underwent a uniform induction chemotherapy between December 2001 and December 2015 at Jichi Medical University. By a repeated-measures analysis of variance, the interaction of the decline in BCP with the achievement of complete remission (CR) was stronger than those of the decline in WBC or BCC. A receiver operating characteristic curve analysis for the achievement of CR showed that the areas under the curve for the decline in WBC, BCP, and BCC were 0.592, 0.703, and 0.634, respectively, and a decline in BCP of 9.25%/day within 4 or 5 days from induction chemotherapy was the optimal cutoff value. A multivariate analysis showed that a rapid decline in BCP (≥9.25%/day) was a significant predictive factor for CR, independent of the cytogenetic risk (p = 0.0096). A rapid decline in BCP during the first 5 days of induction chemotherapy may be a good predictor of CR. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakano
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Shin-Ichiro
authors.initials: SI
authors.lastname: Fujiwara
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Ito
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Mashima
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Kento
authors.initials: K
authors.lastname: Umino
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Minakata
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Yamasaki
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Kawasaki
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Yamamoto
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hatano
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Okazuka
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sato
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Iekuni
authors.initials: I
authors.lastname: Oh
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Ohmine
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Muroi
authors.affiliation: Division of Hematology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019540:Area Under Curve; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D022423:Myeloid Cells / Q000473:pathology*; D016017:Odds Ratio; D011379:Prognosis; D012372:ROC Curve; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: acute myeloid leukemia; blast cell; early clearance; induction chemotherapy; peripheral blood; prognostic factors