Ismail Manar M, Abdulateef Nahla A B
1Laboratory Medicine Department, Faculty of Applied Medical Science, Umm Al Qura University, Al-Abdya, Makkah, Kingdom of Saudi Arabia.
3Clinical Pathology Department, National Cancer Institute, Cairo University, Giza, Egypt.
Indian J Hematol Blood Transfus. 2019 Jan;35(1):100-108. doi: 10.1007/s12288-018-0976-3. Epub 2018 Jul 4.
Leukemia is one of leading causes of death despite the significant improvement of survival. This study aimed at assessing the impact of absolute monocytic count (AMC), and absolute lymphocytic count (ALC) recovery on overall survival (OS) and leukemia free survival (LFS) in AML. 83 de novo AML cases were enrolled in this study. The hemogram parameters including differential leukocyte counts were determined and collected sequentially at days 1, 14, 21 and 28. There was no significant difference regarding AMC or ALC at any time points in relation to the cytogenetics prognostic groups. High AMC ≥ 0.8 × 10/L at day 28 was associated with shorter OS and LFS, value 0.012 and 0.003 respectively. On multivariate models, high AMC was shown as an independent prognostic factor associated with poor OS and LFS (HR 3, 95% CI 1.1-8.1 and value 0.02) and (HR 5, 95% CI 1.5-17.4 and value 0.01) respectively. High ALC-D28 (≥ 0.35 × 10/L) was associated with prolonged OS and LFS survival, value 0.032 and 0.016 respectively. However, it failed to prove the same significance using multivariate analysis. It was concluded that low AMC is an emerging independent predictor of better outcome in AML.
尽管生存率有了显著提高，但白血病仍是主要死因之一。本研究旨在评估绝对单核细胞计数（AMC）和绝对淋巴细胞计数（ALC）恢复对急性髓系白血病（AML）总生存期（OS）和无白血病生存期（LFS）的影响。本研究纳入了83例初发AML病例。在第1、14、21和28天依次测定并收集包括白细胞分类计数在内的血常规参数。在任何时间点，AMC或ALC与细胞遗传学预后分组均无显著差异。第28天AMC≥0.8×10⁹/L与较短的OS和LFS相关，P值分别为0.012和0.003。在多变量模型中，高AMC被证明是与不良OS和LFS相关的独立预后因素（HR 3，95%CI 1.1 - 8.1，P值0.02）和（HR 5，95%CI 1.5 - 17.4，P值0.01）。第28天高ALC（≥0.35×10⁹/L）与延长的OS和LFS相关，P值分别为0.032和0.016。然而，多变量分析未能证明其具有同样的显著性。得出的结论是，低AMC是AML中一个新出现的预后较好的独立预测因素。
