Department of Hematology, The Second Hospital of Shanxi Medical University, Taiyuan, China.
Department of Hematology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital, Taiyuan, China.
J Clin Lab Anal. 2022 Feb;36(2):e24221. doi: 10.1002/jcla.24221. Epub 2022 Jan 3.
Platelet (PLT) recovery after chemotherapy is associated with the prognosis of patients with acute myeloid leukaemia (AML). This study aimed to explore the prognostic significance of early high PLT values in patients with de novo non-M3 AML who achieved first complete remission (CR).
A total of 206 patients with de novo non-M3 AML were analysed in this retrospective study. A receiver operating characteristic (ROC) curve was used to determine the optimal PLT cut-off. The overall survival (OS) and relapse-free survival (RFS) were assessed using Kaplan-Meier and Cox regression analyses.
312×10 /L was confined as the cut-off of the PLT count. The estimated 3-year OS of patients with high PLT was higher than that of their counterparts (72.3% vs. 34.6%, p = 0.001). In subgroup analysis, patients with high PLT had better OS in the favourable- and intermediate-risk (non-adverse-risk) AML (p = 0.001). The estimated 3-year RFS for the high and low PLT groups was 75.1% and 45.7% respectively (p = 0.078). Multivariate analyses revealed that high PLT count was an independent favourable variable for OS (HR = 0.264, p < 0.001) and RFS (HR = 0.375, p = 0.011) in the non-adverse-risk group.
Our results showed that early high PLT count recovery at first CR in non-adverse-risk AML patients is a positive prognostic marker for survival outcomes.
化疗后血小板(PLT)恢复与急性髓系白血病(AML)患者的预后相关。本研究旨在探讨初治非 M3AML 患者首次完全缓解(CR)后早期高 PLT 值的预后意义。
本回顾性研究分析了 206 例初治非 M3AML 患者。采用受试者工作特征(ROC)曲线确定 PLT 计数的最佳截断值。采用 Kaplan-Meier 和 Cox 回归分析评估总生存期(OS)和无复发生存期(RFS)。
以 312×10 /L 为 PLT 计数的截断值。高 PLT 患者的估计 3 年 OS 高于低 PLT 患者(72.3% vs. 34.6%,p=0.001)。亚组分析显示,在有利和中间风险(非不良风险)AML 中,高 PLT 患者具有更好的 OS(p=0.001)。高和低 PLT 组的估计 3 年 RFS 分别为 75.1%和 45.7%(p=0.078)。多因素分析显示,高 PLT 计数是非不良风险组 OS(HR=0.264,p<0.001)和 RFS(HR=0.375,p=0.011)的独立有利因素。
我们的研究结果表明,非不良风险 AML 患者首次 CR 时早期高 PLT 计数恢复是生存结局的一个积极预后标志物。