Hyper-recovery of platelets after induction therapy is a predictor of relapse-free survival in acute myeloid leukemia.
We verified the association between standard clinical and laboratory variables and the risk of relapse in acute myeloid leukemia (AML), which led us to retrospectively examine the effect of regeneration of hematopoiesis in patients with newly diagnosed AML. We used data from 230 patients who obtained remission after cytarabine-based induction chemotherapy. Platelet counts ≥500 × 109/L and hemoglobin levels ≥9 g/dL on day 28 after treatment initiation were significantly associated with relapse-free survival (RFS) rate, conferring respective multivariate risk ratios of 0.38 (95% CI: 0.18-0.79) and 0.60 (95% CI: 0.40-0.89) for the occurrence of relapse or death. No disease relapse occurred in core binding factor leukemia patients whose platelet counts recovered ≥500 × 109/L at 28 days after therapy initiation. We conclude that regeneration of hematopoiesis, especially platelet hyper-recovery, after induction chemotherapy is a significant predictor of RFS in patients with AML.
a Department of Internal Medicine and Clinical Immunology , Yokohama City University Graduate School of Medicine , Yokohama, Japan.
Etsuko
E
Yamazaki
b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan.
Heiwa
H
Kanamori
c Department of Hematology , Yokohama City University Medical Center , Yokohama , Japan.
Megumi
M
Itabashi
b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan.
Eriko
E
Ogusa
c Department of Hematology , Yokohama City University Medical Center , Yokohama , Japan.
Ayumi
A
Numata
b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan.
Wataru
W
Yamamoto
d Department of Hematology , Shizuoka Red Cross Hospital , Shizuoka , Japan.
Satomi
S
Ito
a Department of Internal Medicine and Clinical Immunology , Yokohama City University Graduate School of Medicine , Yokohama, Japan.
Takayoshi
T
Tachibana
c Department of Hematology , Yokohama City University Medical Center , Yokohama , Japan.
Maki
M
Hagihara
b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan.
Kenji
K
Matsumoto
e Department of Hematology/Oncology , Yamato Municipal Hospital , Yamato , Japan.
Hideyuki
H
Koharazawa
d Department of Hematology , Shizuoka Red Cross Hospital , Shizuoka , Japan.
Jun
J
Taguchi
a Department of Internal Medicine and Clinical Immunology , Yokohama City University Graduate School of Medicine , Yokohama, Japan.
Naoto
N
Tomita
f Department of Hematology/Immunology , Fujisawa City Hospital , Fujisawa , Japan.
Katsumichi
K
Fujimaki
g Department of Hematology , Saiseikai Yokohama Nanbu Hospital , Yokohama , Japan.
Hiroyuki
H
Fujita
c Department of Hematology , Yokohama City University Medical Center , Yokohama , Japan.
Shin
S
Fujisawa
h Department of Hematology , Yokosuka City Hospital , Yokosuka , Japan.
Koji
K
Ogawa
a Department of Internal Medicine and Clinical Immunology , Yokohama City University Graduate School of Medicine , Yokohama, Japan.
Yoshiaki
Y
Ishigatsubo
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D055815:Young Adult
D015415:Biomarkers
Acute myeloid leukemia; hematopoiesis; platelet recovery; prognostic factor; relapse-free survival