Abstract
Objective:The prognosis of patients with acute myeloid leukemia (AML) is affected by factors that are both patient- and disease-specific. The aim of this study is to evaluate the impact of early versus late platelet and neutrophil recovery after induction chemotherapy on survival outcomes of AML patients.Materials and Methods:A total of 181 patients with AML who were treated in our tertiary center between 2001 and 2018 were evaluated. Neutrophil and platelet recovery times were accepted as the periods from the beginning of induction chemotherapy to a neutrophil count of ≥0.5x109/L and a platelet count of ≥20x109/L 3 days in a row, respectively. The median time to platelet recovery was 25 days (range=12-52) for all patients. Therefore, platelet recovery in the first 25 days was defined as early platelet recovery (EPR) and at ≥26 days it was defined as late platelet recovery (LPR). The median time to neutrophil recovery was 28 days (range=13-51) for all patients. Therefore, neutrophil recovery in the first 28 days was defined as early neutrophil recovery, and at ≥29 days it was defined as late neutrophil recovery.Results:The 5-year overall survival (OS) rates for patients who had EPR and LPR after induction chemotherapy were 62% and 23%, respectively (p<0.001). The 5-year disease-free survival (DFS) rates for patients who had EPR and LPR after induction chemotherapy were 57% and 15%, respectively (p<0.001).Conclusion:Short bone marrow recovery time may indicate better healthy hematopoiesis and marrow capacity associated with longer OS and DFS.
Highlights
The clinical outcome of patients with acute myeloid leukemia (AML) varies across a wide spectrum, ranging from survival of a few days to remission
Short bone marrow recovery time may indicate better healthy hematopoiesis and marrow capacity associated with longer overall survival (OS) and disease-free survival (DFS)
Karyotype analyses were available for 159 patients: 6 patients (3.7%) were in the favorable-risk group, 101 (63.5%) patients were in the intermediate-risk group, and 54 (33.9%) patients were in the adverse-risk group according to the European LeukemiaNet classification [9]
Summary
The clinical outcome of patients with acute myeloid leukemia (AML) varies across a wide spectrum, ranging from survival of a few days to remission. Prognosis of patients with AML is affected by factors that are both patient- and diseasespecific. The most significant disease-specific prognostic factors at the time of diagnosis of AML are cytogenetics and molecular abnormalities [2]. The most important patient-specific prognostic factor is age at diagnosis [3]. Estimating resistance to treatment in patients with AML is extremely important for critical therapeutic decisions and follow-up of the patient [4]. Very limited data are available regarding the association between AML prognosis and bone marrow recovery kinetics following induction chemotherapy [5,6,7]. The aim of this study was to evaluate the impact of early versus late platelet and neutrophil recovery after induction chemotherapy on the survival outcomes of AML patients
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