Monocytes-neutrophils-ratio as predictive marker for failure of first induction therapy in AML.
Blood Cells Mol Dis
; 77: 103-108, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-31029023
ABSTRACT
INTRODUCTION:
Acute myeloid leukemia (AML) is, if untreated, a fatal hematologic neoplasia. Failure of the first induction chemotherapy is a hallmark for a poor prognosis. Early recognition of therapy failure is crucial for planning further therapies. Therefore, international guidelines recommend a bone marrow biopsy around day 14 after the beginning of induction therapy. Hypocellular bone marrow on day 14 is still gold standard for therapy assessment and further therapy strategy. Despite this, non-invasive ways for the evaluation of induction therapy were looked for in the past years.METHODS:
We collected peripheral blood cell counts and routine laboratory values of patients treated with "7â¯+â¯3" induction therapy. Ratios of absolute cell counts of monocytes and neutrophils (MNR) were calculated daily, and the values were compared in patients with failure of the first induction therapy and patients with therapy response.RESULTS:
54 patients were included, 12 of which had failure of first induction therapy. The MNR following therapy was highly correlated with the bone marrow results. With the right cut-off, the MNR provides a valid and reliable tool for identification of patients with failure of first induction therapy with a sensitivity of 83.3% and a specificity of 87.8% on day 18.CONCLUSIONS:
We propose a novel and non-invasive method for detection of failure of first induction therapy in patients with de novo AML and "7â¯+â¯3" induction therapy. The MNR is free of cost since the required cell counts are performed routinely for each patient undergoing intensive chemotherapy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Monócitos
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Leucemia Mieloide Aguda
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Contagem de Leucócitos
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Neutrófilos
Tipo de estudo:
Diagnostic_studies
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Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
Idioma:
En
Revista:
Blood Cells Mol Dis
Ano de publicação:
2019
Tipo de documento:
Article