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Prognostic value of complete remission with superior platelet counts in acute myeloid leukemia.
- Source :
-
The Journal of community and supportive oncology [J Community Support Oncol] 2016 Feb; Vol. 14 (2), pp. 66-71. - Publication Year :
- 2016
-
Abstract
- Background: Complete remission (CR) in acute myeloid leukemia (AML) is defined as having ≤5% leukemic blast cells in the bone marrow and return of normal hematopoiesis after the first induction cycle. There is a subset of patients, however, who achieve reduction of leukemic blast cells with a subnormal platelet count, designated as CR with incomplete platelet recovery (platelet count, ≤100,000/mcL; normal, 150,000-450,000/mcL), which is associated with inferior outcomes when compared with CR. Furthermore, there is another subset of patients with CR but superior platelet counts (≥400,000/mcL) whose prognostic significance is unclear.<br />Objective: To establish whether CR with superior platelet counts is associated with better outcomes and can be used as a separate entity for prognostication.<br />Methods: A retrospective chart review of 104 cases of AML was conducted. The highest platelet count during days 25-35 from initiation of induction chemotherapy (designated as day 30 platelet count) was documented. A multivariate analysis for other factors such as age, sex, risk categories, day 14+ plasma cell count (average plasma cell percentage at days 14-21), infections, allogeneic bone marrow transplant, and remission status was done.<br />Results: Day 30 platelet count was found to be an independent predictor of survival in AML. On the multivariate analysis, the subgroup with superior platelet counts (≥400,000/mcL) was found to be associated with better outcomes.<br />Limitations: Results need to be validated in a larger cohort.<br />Conclusions: CR with superior platelet recovery (≥400,000/mcL) is a unique subcategory in itself and has prognostic significance. This may help better assess response to chemotherapeutic agents and aid in further decision-making regarding treatment.<br /> (©2016 Frontline Medical Communications.)
Details
- Language :
- English
- ISSN :
- 2330-7749
- Volume :
- 14
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of community and supportive oncology
- Publication Type :
- Academic Journal
- Accession number :
- 26955659
- Full Text :
- https://doi.org/10.12788/jcso.0231