Effect of Hematopoietic Function Recovery and MRD Status after Induction Chemotherapy on the Prognosis of Patients with Newly Diagnosed Acute Myeloid Leukemia

Ruijuan MA; Feng ZHANG; Ruiting ZHANG; Jin YAO

doi:10.12259/j.issn.2095-610X.S20220512

Volume 43 Issue 5

May 2022

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Ruijuan MA, Feng ZHANG, Ruiting ZHANG, Jin YAO. Effect of Hematopoietic Function Recovery and MRD Status after Induction Chemotherapy on the Prognosis of Patients with Newly Diagnosed Acute Myeloid Leukemia[J]. Journal of Kunming Medical University, 2022, 43(5): 88-94. doi: 10.12259/j.issn.2095-610X.S20220512

Citation:

Ruijuan MA, Feng ZHANG, Ruiting ZHANG, Jin YAO. Effect of Hematopoietic Function Recovery and MRD Status after Induction Chemotherapy on the Prognosis of Patients with Newly Diagnosed Acute Myeloid Leukemia[J]. Journal of Kunming Medical University, 2022, 43(5): 88-94. doi: 10.12259/j.issn.2095-610X.S20220512

Citation:

Ruijuan MA, Feng ZHANG, Ruiting ZHANG, Jin YAO. Effect of Hematopoietic Function Recovery and MRD Status after Induction Chemotherapy on the Prognosis of Patients with Newly Diagnosed Acute Myeloid Leukemia[J]. Journal of Kunming Medical University, 2022, 43(5): 88-94. doi: 10.12259/j.issn.2095-610X.S20220512

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Effect of Hematopoietic Function Recovery and MRD Status after Induction Chemotherapy on the Prognosis of Patients with Newly Diagnosed Acute Myeloid Leukemia

doi: 10.12259/j.issn.2095-610X.S20220512

1.
Dept. of Hematology，The 2nd Affiliated Hospital of Kunming Medical University ，KunmingYunnan 650101
2.
Dept. of Hematology，The 1st People’s Hospital of Kunming，Kunming Yunnan 650034，China

Received Date: 2022-01-15
Available Online: 2022-05-06
Publish Date: 2022-05-27

Abstract

Abstract

Objective To investigate the recovery of hematopoietic function after the induction chemotherapy and the effect of MRD status on the prognosis of AML by analyzing retrospectively the clinical data of 100 newly diagnosed AML patients. Methods The clinical data of 100 patients with acute myeloid leukemia initially diagnosed in the Department of Hematology of the Second Affiliated Hospital of Kunming Medical University from January 2017 to March 2021 were retrospectively analyzed. The differences of clinical characteristics between complete recovery group （CR） and incomplete recovery group （CRi or CRp） and the differences of OS and EFS between the two groups were compared and analyzed. Cox regression was used to analyze the risk factors affecting the prognosis. The difference of OS and EFS between the platelet complete recovery group （PLT ≥ 300×10⁹ / L） and the incomplete recovery group （PLT < 300×10⁹ / L） on the 28th day after the induction treatment was compared and analyzed. The differences of various parameters were evaluated by independent sample t-test, Pearson chi-square test or Mann-Whitney test. Kaplan-Meier method and Cox regression were used for survival analysis. Results The median follow-up time was 1.6 （0.9, 2.6） a. The comparison between CR group and CRp or CRi group showed that there were significant differences in MRD status, prognostic genes （NPM1, FLT3-ITD, C-KIT, CEBPA） and prognosis between the two groups （P < 0.05）; AML patients with incomplete recovery of peripheral blood cell count during the morphological remission predicted worse outcomes. The overall survival time （OS） in the incomplete recovery group （CRi or CRp） was significantly shorter than that in the complete recovery group （CR）（3.2 a VS 1.8 a, P = 0.016）; And the progression free survival （EFS） was also significantly shortened （less than 1.2 a, P = 0.041）. On the 28th day of the induction treatment, the overall survival （OS） of incomplete platelet recovery group （PLT < 300×10⁹ / L） was significantly shorter than that of complete platelet recovery group （PLT ≥ 300 ×10⁹ / L）（5.2 a vs 2.5 a, P = 0.001）; EFS was also shortened （3.2 a VS 2.7 a, P = 0.237）. Cox regression analysis showed that platelet recovery on day 28 and MRD status in morphological remission were independent risk factors affecting the prognosis of AML patients. Conclusion For newly diagnosed AML patients, hematopoietic regeneration after the induction chemotherapy, especially the recovery of platelets, is an important predictor of the prognosis of AML patients. Although hematopoietic recovery and MRD status are related, both are independent prognostic factors for recurrence, OS and EFS in patients with AML.
- Acute myeloid leukemia,
- Hematopoietic function recovery,
- Platelets on day 28,
- MRD status,
- Prognosis

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