Abstract |
In patients with acute myeloid leukemia (AML), rapid reduction of circulating blasts with induction chemotherapy may serve as an in vivo marker of chemosensitivity. We performed a retrospective analysis of 363 patients with untreated AML who received induction chemotherapy in order to determine the relationship between day of blast disappearance (DOBD) and complete remission (CR) rates, event-free survival (EFS), and overall survival (OS). DOBD ≤ 5 vs. >5 was identified as the most discriminating cutoff for OS. DOBD > 5 was observed in 35 patients (9.6%). The CR rate for patients with DOBD ≤ 5 vs. >5 was 74.0 and 28.6%, median EFS was 9.4 and 1.8 months, and median OS was 17.1 and 5.8 months, respectively (P < 0.001 for all). DOBD > 5 was independently associated with a lower CR rate and shorter EFS and OS (P < 0.001 for all). DOBD > 5 retained prognostic significance for EFS and OS when patients were stratified by cytogenetic risk group, de novo vs. secondary or therapy-related AML, European LeukemiaNet-based risk groups, and whether CR was achieved. We propose DOBD > 5 as a simple and early marker of disease resistance that identifies patients with poor prognosis who otherwise may not be identified with existing risk stratification systems. Am. J. Hematol. 91:1221-1226, 2016. © 2016 Wiley Periodicals, Inc.
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Authors | Nicholas J Short, Christopher B Benton, Hsiang-Chun Chen, Peng Qiu, Lisa Gu, Sherry Pierce, Mark Brandt, Abhishek Maiti, Taejin L Min, Kiran Naqvi, Alfonso Quintas-Cardama, Marina Konopleva, Tapan Kadia, Jorge Cortes, Guillermo Garcia-Manero, Farhad Ravandi, Elias Jabbour, Hagop Kantarjian, Michael Andreeff |
Journal | American journal of hematology
(Am J Hematol)
Vol. 91
Issue 12
Pg. 1221-1226
(12 2016)
ISSN: 1096-8652 [Electronic] United States |
PMID | 27474808
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | © 2016 Wiley Periodicals, Inc. |
Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Biomarkers
(blood)
- Blast Crisis
(blood, mortality, pathology)
- Disease-Free Survival
- Humans
- Induction Chemotherapy
(methods)
- Leukemia, Myeloid, Acute
(diagnosis, drug therapy, mortality, pathology)
- Middle Aged
- Prognosis
- Remission Induction
(methods)
- Retrospective Studies
- Risk Factors
- Survival Analysis
- Time Factors
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