title: [Prognostic significance of blood count at the time of achieving morphologic leukemia-free state in adults with acute myeloid leukemia].
abstract: Objective:To explore prognostic significance of blood count at the time of achieving first morphologic leukemia-free state[complete remission (CR, ANC ≥1×10(9)/L and PLT ≥100×10(9)/L) , CR with incomplete PLT recovery (CRp) and CR with incomplete ANC and PLT recovery (CRi) ]in adult patients with de novo acute myeloid leukemia (AML) .Methods:From January 2008 to February 2016, data of consecutive newly-diagnosed AML (non-APL) adults who received continuous chemotherapy in our hospital were analyzed retrospectively.Results:352 patients were included in the study. 179 (50.9%) were male. Median age was 44 (17-65) years. Using the SWOG cytogenetic classification, 87 (24.7%) , 171 (48.6%) , 46 (13.1%) and 48 (13.6%) patients belonged to favorable, intermediate, unfavorable and unknown categories, respectively. 16 (4.5%) had monosomal karyotype and 41 (11.6%) had FLT3-ITD mutation positive. Best response achieved at the time of achieving first morphologic leukemia-free state was CR in 299 (84.9%) patients, CRp in 26 (7.4%) and CRi in 27 (8.1%) . With a median follow-up period of 16 (2-94) months in survivors, the probabilities of cumulative incident of relapse (CIR) rate, disease free survival (DFS) and overall survival (OS) at 30 months were 47.5%, 46.0% and 58.6%, respectively. Multivariate analyses showed that non-CR (CRp or CRi) , was associated with high relapse rate, shorter DFS and OS. In addition, intermediate or high risk of SWOG cytogenetic classification and FLT3-ITD positive were common unfavorable factors affecting CIR, DFS and OS. Peripheral blast ≥60% at diagnosis was adverse factors affecting DFS. Age ≥48 years and bone marrow blasts ≥67% were associated with shorter OS.Conclusion:Blood count at the time of achieving morphologic leukemia-free state was one of the key markers associated with treatment outcomes in adults with AML.
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors.forename: X
authors.initials: X
authors.lastname: Ren
authors.forename: T
authors.initials: T
authors.lastname: Zhao
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.forename: H H
authors.initials: HH
authors.lastname: Zhu
authors.forename: H
authors.initials: H
authors.lastname: Jiang
authors.forename: J S
authors.initials: JS
authors.lastname: Jia
authors.forename: S M
authors.initials: SM
authors.lastname: Yang
authors.forename: B
authors.initials: B
authors.lastname: Jiang
authors.forename: D B
authors.initials: DB
authors.lastname: Wang
authors.forename: X J
authors.initials: XJ
authors.lastname: Huang
authors.forename: Q
authors.initials: Q
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D001772:Blood Cell Count; D003582:Cytogenetics; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Blood cell count; Leukemia, myeloid, acute; Prognosis; Remission induction