Prognostic value of platelet recovery degree before and after achieving minimal residual disease negative complete remission in acute myeloid leukemia patients

被引:7
作者
Wang, Yang [1 ,2 ]
Wang, Hua [1 ,2 ]
Wang, Weida [1 ,2 ]
Liu, Wenjian [1 ,2 ]
Liu, Nawei [1 ,2 ]
Liu, Shuang [1 ,2 ]
Lu, Yue [1 ,2 ]
机构
[1] Sun Yat Sen Univ, Ctr Canc, Dept Hematol Oncol, 651 Dongfengdong Rd, Guangzhou 510060, Peoples R China
[2] Collaborat Innovat Ctr Canc Med, State Key Lab Oncol Southern China, Guangzhou 510060, Peoples R China
基金
中国国家自然科学基金;
关键词
Acute myeloid leukemia (AML); Complete remission (CR); Platelet recovery degree; Progression free survival (PFS); Overall survival (OS); WORLD-HEALTH-ORGANIZATION; INDUCTION THERAPY; CLASSIFICATION; AML; MICROENVIRONMENT; CHEMOTHERAPY; NEOPLASMS; SURVIVAL; REVISION;
D O I
10.1186/s12885-020-07222-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundRisk stratification and prognosis prediction of acute myeloid leukemia (AML) are largely dependent on pre-treatment information. However, post-treatment data also provides much useful information. In this retrospective study, we explored whether the level of blood count recovery before and after the first minimal residual disease (MRD) negative complete remission (CR) is relevant to clinical outcomes of AML patients.MethodsFor each included patient, peripheral platelet counts were measured on the day before initial treatment (PLTpre), whereas platelet peak values (PLTpeak) were recorded after marrow recovery following the chemotherapy course inducing the first MRD-negative CR. The difference (D-PLT) between these two values (D-PLT=PLTpeak-PLTpre) was calculated. X-tile software was utilized to establish the optimal cut-point for D-PLT, which was expected to distinguish CR patients with different clinical outcomes. A cross validation analysis was conducted to confirm the robustness of the established cut-point. The results were further tested by a Cox multivariate analysis.ResultsThe optimal cut-point of D-PLT was determined as 212x10(9)/L. Patients in high D-PLT group were observed to have a significantly better PFS (p=0.016) and a better OS (without statistical significance, p=0.106). Cox multivariate analysis showed that higher D-PLT was associated with longer PFS (HR=2.894, 95% CI: 1.320-6.345, p=0.008) and longer OS (HR=3.077, 95% CI: 1.130-8.376, p=0.028).ConclusionPlatelet recovery degree before and after achieving MRD-negative CR (D-PLT) is a potential predictor of clinical outcomes in CR patients. Higher D-PLT value is associated with longer PFS and OS. Our findings may help to develop simple methods for AML prognosis evaluation.
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页数:8
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