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诱导化疗后出现的反应性血小板增多是急性髓系白血病患者首次达到完全缓解时预后良好的独立预测因素。

Rebound Thrombocytosis following Induction Chemotherapy is an Independent Predictor of a Good Prognosis in Acute Myeloid Leukemia Patients Attaining First Complete Remission.

作者信息

Malkan Umit Yavuz, Gunes Gursel, Isik Ayse, Eliacik Eylem, Etgul Sezgin, Aslan Tuncay, Balaban Muruvvet Seda, Haznedaroglu Ibrahim Celalettin, Demiroglu Haluk, Goker Hakan, Ozcebe Osman Ilhami, Sayınalp Nilgun, Aksu Salih, Buyukasik Yahya

机构信息

Department of Hematology, School of Medicine, Hacettepe University, Ankara, Turkey.

出版信息

Acta Haematol. 2015;134(1):32-7. doi: 10.1159/000369917. Epub 2015 Apr 8.

Abstract

There are very few data about the relationship between acute myeloid leukemia (AML) prognosis and bone marrow recovery kinetics following chemotherapy. In this study, we aimed to assess the prognostic importance and clinical associations of neutrophil and platelet recovery rates and rebound thrombocytosis (RT) or neutrophilia (RN) in the postchemotherapy period for newly diagnosed AML patients. De novo AML patients diagnosed between October 2002 and December 2013 were evaluated retrospectively. One hundred patients were suitable for inclusion. Cox regression analysis using need for reinduction chemotherapy as a stratification parameter revealed RT as the only parameter predictive of OS, with borderline statistical significance (p = 0.06, OR = 7; 95% CI 0.92-53), and it was the only parameter predictive of DFS (p = 0.024, OR = 10; 95% CI 1.3-75). In order to understand whether RT or RN was related to a better marrow capacity or late consolidation, we considered neutrophil recovery time and platelet recovery time and nadir-first consolidation durations in all patients in the cohort. Both the marrow recovery duration and the time between marrow aplasia and first consolidation were shorter in RT and RN patients. To our knowledge, this is the first study to report a correlation between RT/RN and prognosis in AML.

摘要

关于急性髓系白血病(AML)预后与化疗后骨髓恢复动力学之间关系的数据非常少。在本研究中,我们旨在评估新诊断AML患者化疗后中性粒细胞和血小板恢复率以及血小板反跳性增多(RT)或中性粒细胞增多(RN)的预后重要性及临床相关性。对2002年10月至2013年12月期间诊断的初发AML患者进行回顾性评估。100例患者适合纳入研究。以是否需要再次诱导化疗作为分层参数的Cox回归分析显示,RT是唯一预测总生存期(OS)的参数,具有临界统计学意义(p = 0.06,OR = 7;95%CI 0.92 - 53),并且它是唯一预测无病生存期(DFS)的参数(p = 0.024,OR = 10;95%CI 1.3 - 75)。为了了解RT或RN是否与更好的骨髓功能或晚期巩固治疗相关,我们考虑了队列中所有患者的中性粒细胞恢复时间、血小板恢复时间以及最低点至首次巩固治疗的持续时间。RT和RN患者的骨髓恢复持续时间以及骨髓再生障碍至首次巩固治疗的时间均较短。据我们所知,这是第一项报道RT/RN与AML预后之间存在相关性的研究。

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