Yimin Zhang1, Haihui Gu2, Qi Chen3, Ying Zhang1, Hui Cheng1, Jianmin Yang1, Jianmin Wang1, Xiaoxia Hu4. 1. Department of Hematology, Institute of Hematology, Changhai Hospital, Shanghai, China. 2. Department of Transfusion Medicine, Changhai Hospital, Shanghai, China. 3. Department of Health Statistics, Second Military Medical University, Shanghai, China. 4. Department of Hematology, Institute of Hematology, Changhai Hospital, Shanghai, China, hu_xiaoxia@126.com.
Abstract
BACKGROUND: Aggressive growth of primitive and immature cells in the bone marrow results in reductions in megakaryocyte and platelet (PLT) counts, leading to thrombocytopenia in acute myeloid leukemia (AML). However, not all AML patients show thrombocytopenia at the time of diagnosis, and the association of PLT count with patient survival is largely unknown. METHODS: A retrospective study was performed to determine PLT counts at diagnosis in the peripheral blood in 291 newly diagnosed AML patients and assess the association of PLT counts with the overall survival (OS) and disease-free survival (DFS) of these patients. RESULTS: Low PLT counts (≤40 × 109/L) were associated with better outcomes for the whole cohort (5-year OS, 55.1 ± 3.8 vs. 35.3 ± 3.5%, p < 0.001; 5-year DFS, 49.1 ± 3.8 vs. 25.7 ± 4.0%, p < 0.001) and intermediate-risk patients (5-year OS, 64.5 ± 5.4 vs. 41.0 ± 4.8%, p < 0.001; 5-year DFS, 60.8 ± 5.6 vs. 28.6 ± 5.6%, p < 0.001). Moreover, low PLT counts were related to deeper molecular remission. Low PLT counts correlated with better survival of intermediate-risk AML patients treated with chemotherapy only. Allogeneic hematopoietic stem cell transplantation attenuated the negative impact of high PLT counts on the survival of intermediate-risk patients. Furthermore, univariate and multivariate analyses demonstrated that PLT count at diagnosis was an independent prognostic factor for intermediate-risk AML. CONCLUSION: PLT count at diagnosis predicts survival for patients with intermediate-risk AML.
BACKGROUND: Aggressive growth of primitive and immature cells in the bone marrow results in reductions in megakaryocyte and platelet (PLT) counts, leading to thrombocytopenia in acute myeloid leukemia (AML). However, not all AMLpatients show thrombocytopenia at the time of diagnosis, and the association of PLT count with patient survival is largely unknown. METHODS: A retrospective study was performed to determine PLT counts at diagnosis in the peripheral blood in 291 newly diagnosed AMLpatients and assess the association of PLT counts with the overall survival (OS) and disease-free survival (DFS) of these patients. RESULTS: Low PLT counts (≤40 × 109/L) were associated with better outcomes for the whole cohort (5-year OS, 55.1 ± 3.8 vs. 35.3 ± 3.5%, p < 0.001; 5-year DFS, 49.1 ± 3.8 vs. 25.7 ± 4.0%, p < 0.001) and intermediate-risk patients (5-year OS, 64.5 ± 5.4 vs. 41.0 ± 4.8%, p < 0.001; 5-year DFS, 60.8 ± 5.6 vs. 28.6 ± 5.6%, p < 0.001). Moreover, low PLT counts were related to deeper molecular remission. Low PLT counts correlated with better survival of intermediate-risk AMLpatients treated with chemotherapy only. Allogeneic hematopoietic stem cell transplantation attenuated the negative impact of high PLT counts on the survival of intermediate-risk patients. Furthermore, univariate and multivariate analyses demonstrated that PLT count at diagnosis was an independent prognostic factor for intermediate-risk AML. CONCLUSION: PLT count at diagnosis predicts survival for patients with intermediate-risk AML.
Authors: A J Huang; L Gao; X Ni; X X Hu; G S Tang; H Cheng; J Chen; L Chen; L X Liu; C C Wang; W P Zhang; J M Yang; J M Wang Journal: Zhonghua Xue Ye Xue Za Zhi Date: 2021-05-14