Normal Absolute Monocyte Count in Combination with Normal/High Absolute Lymphocyte Count at the Time of Relapse is Associated with Improved Survival in Patients with Early Relapsed Acute Myeloid Leukemia.

This study aimed to examine the prognostic significance of peripheral absolute monocyte count (AMC) in combination with absolute lymphocyte count (ALC) at the time of relapse in a cohort of 57 patients with early relapsed (first complete remission <12 months) acute myeloid leukemia (AML). Both univariate and multivariate Cox proportional hazard regression analyses revealed that normal AMC in combination with normal/high ALC (versus low/high AMC in combination with low ALC) was significantly associated with improved OS. We concluded that the combination of AMC and ALC could be used as a prognostic marker for survival outcomes in early relapsed AML.

Neutrophil-to-lymphocyte ratio correlates with prognosis and response to chemotherapy in patients with non-M3 de novo acute myeloid leukemia.

BACKGROUND: Neutrophil-to-lymphocyte (NLR) ratio can predict survival outcome and assess response to chemotherapy in several tumors. However, the values of NLR in acute myeloid leukemia (AML) remains unknown. METHODS: A retrospective review of 181 patients with de novo AML excluding acute promyelocytic leukemia (M3) was conducted in our institute. We categorized the patients into two groups by defining NLR =2.0 as the cut-off point. NLR was calculated by the ratio of the number of neutrophils to lymphocytes in the peripheral blood (PB). The baseline clinicopathologic parameters were compared using Chi-squared test or Kruskal-Wallis H test. Kaplan-Meier analysis was used to assess survival, and overall survival (OS) and disease-free survival (DFS) were analyzed using the Cox regression with log-rank tests. RESULTS: We found AML patients with low NLR (<2.0) had longer OS and DFS than those with high NLR (≥2.0). NLR, absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) were significantly associated with OS and DFS in all AML patients. NLR, ANC, and ALC were associated with OS and DFS only in those case with myeloblasts over 50% in bone marrow (BM). Furthermore, the median NLR was dramatically increased in low NLR group when patients achieved complete remission (CR). CONCLUSIONS: Pretreatment NLR as a marker can predict the prognosis and NLR can assess the response to chemotherapy in patients with non-M3 AML, especially in those cases with myeloblasts over 50% in BM.

Plasma fibrinogen levels correlate with prognosis and treatment outcome in patients with non-M3 acute myeloid leukemia.

To assess plasma fibrinogen levels as a biomarker to predict the prognosis and treatment outcome in acute myeloid leukemia (AML), a retrospective study of 215 patients with AML excluding M3 was conducted in a single center. Patients were divided into low and high group according to the cutoff value of 3.775 g/L obtained by analyzing the receiver operating characteristic (ROC) curve of fibrinogen at diagnosis. Importantly, overall survival (OS) was markedly better in low fibrinogen group (p=.006) as well as disease-free survival (DFS) (p= .045). Furthermore, when patients achieved complete remission (CR), the median plasma fibrinogen levels were dramatically decreased in high fibrinogen group but increased in low fibrinogen group. In conclusion, our data suggest that initial plasma FBG levels can be used as an independent prognostic biomarker affecting OS and DFS, as well as a potential parameter reflecting the treatment outcome in patients with non-M3 AML.

Pretreatment platelet count predicts survival outcome of patients with de novo non-M3 acute myeloid leukemia.

BACKGROUND: Pretreatment platelet count has been reported as a potential tool to predict survival outcome in several solid tumors. However, the predictive value of pretreatment platelet count remains obscure in de novo acute myeloid leukemia (AML) excluding acute promyelocytic leukemia (M3). METHODS: We conducted a retrospective review of 209 patients with de novo non-M3 AML in our institute over a period of 8 years (2007-2015). Receiver operating characteristic (ROC) curve analysis was used to determine the optimal platelet (PLT) cutoff in patients. We analyzed the overall survival (OS) and disease free survival (DFS) using the log-rank test and Cox regression analysis. RESULTS: By defining the platelet count 50 × 109/L and 120 × 109/L as two cut-off points, we categorized the patients into three groups: low (<50 × 109/L), medium (50-120 × 109/L) and high (>120 × 109/L). On univariate analysis, patients with medium platelet count had longer OS and DFS than those with low or high platelet count. However, the multivariate analysis showed that only longer DFS was observed in patients with medium platelet count than those with low or high platelet count. CONCLUSION: Our findings indicate that pretreatment platelet count has a predictive value for the prognosis of patients with non-M3 AML.