Are the conventional risk factors still valid for acute myeloid leukemia patients?

Year 2020, Volume: 12 Issue: 1, 5 - 11, 02.03.2020

Abdulkerim Yıldız Senem Maral Murat Albayrak Çiğdem Pala Pınar Cömert Hacer Berna Afacan Öztürk Osman Şahin

https://doi.org/10.18521/ktd.549666

Abstract

Objective: The
aim of this study was to investigate the survival data of patients with acute
myeloid leukemia (AML) and to determine the risk factors that can be easily evaluated.

Method: A
retrospective analysis  was made of the AML patients admitted to our center between
2009-2018. Demographic data and disease data were analyzed and response rates,
overall survival (OS) and progression-free survival (PFS) rates were
calculated. Factors affecting survival were determined using Cox-regression
analysis.

Results: A
total of 119 patients were included in the study during the 9-year study
period. Of these, 21 patients had secondary AML and 11 had acute promyelocytic
leukemia (APL). The mean follow-up period was 12.43 ± 15.63 months. OS of all
patients was 9.20 months and PFS was 7.23 months. Age and leukocyte count at
the time of diagnosis were found to have a significant impact on both OS and
PFS (p <0.05).

Conclusion:
In addition to genetic and molecular features, which are expensive and not
easily available, the age and leukocyte count of AML patients remain important as
prognostic factors.

Keywords

leukemia, survival, age

References

• 1. Dohner H, Estey EH, Amadori S, Appelbaum FR, Buchner T, Burnett AK, et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood. 2010;115(3):453-74.
• 2. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA: a cancer journal for clinicians. 2012;62(1):10-29.
• 3. Ferrara F, Schiffer CA. Acute myeloid leukaemia in adults. Lancet (London, England). 2013;381(9865):484-95.
• 4. Padilha SL, Souza EJ, Matos MC, Domino NR. Acute myeloid leukemia: survival analysis of patients at a university hospital of Parana. Revista brasileira de hematologia e hemoterapia. 2015;37(1):21-7.
• 5. Rollig C, Ehninger G. How I treat hyperleukocytosis in acute myeloid leukemia. Blood. 2015;125(21):3246-52.
• 6. Grimwade D. The changing paradigm of prognostic factors in acute myeloid leukaemia. Best practice & research Clinical haematology. 2012;25(4):419-25.
• 7. Liersch R, Muller-Tidow C, Berdel WE, Krug U. Prognostic factors for acute myeloid leukaemia in adults--biological significance and clinical use. British journal of haematology. 2014;165(1):17-38.
• 8. Duployez N, Willekens C, Marceau-Renaut A, Boudry-Labis E, Preudhomme C. Prognosis and monitoring of core-binding factor acute myeloid leukemia: current and emerging factors. Expert review of hematology. 2015;8(1):43-56.
• 9. Stone RM. The difficult problem of acute myeloid leukemia in the older adult. CA: a cancer journal for clinicians. 2002;52(6):363-71.
• 10. Dohner H, Estey E, Grimwade D, Amadori S, Appelbaum FR, Buchner T, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017;129(4):424-47.
• 11. Juliusson G, Antunovic P, Derolf A, Lehmann S, Mollgard L, Stockelberg D, et al. Age and acute myeloid leukemia: real world data on decision to treat and outcomes from the Swedish Acute Leukemia Registry. Blood. 2009;113(18):4179-87.
• 12. Medinger M, Lengerke C, Passweg J. Novel Prognostic and Therapeutic Mutations in Acute Myeloid Leukemia. Cancer genomics & proteomics. 2016;13(5):317-29.
• 13. Mamez AC, Raffoux E, Chevret S, Lemiale V, Boissel N, Canet E, et al. Pre-treatment with oral hydroxyurea prior to intensive chemotherapy improves early survival of patients with high hyperleukocytosis in acute myeloid leukemia. Leukemia & lymphoma. 2016;57(10):2281-8.
• 14. Kuo KH, Callum JL, Panzarella T, Jacks LM, Brandwein J, Crump M, et al. A retrospective observational study of leucoreductive strategies to manage patients with acute myeloid leukaemia presenting with hyperleucocytosis. British journal of haematology. 2015;168(3):384-94.
• 15. Greenwood MJ, Seftel MD, Richardson C, Barbaric D, Barnett MJ, Bruyere H, et al. Leukocyte count as a predictor of death during remission induction in acute myeloid leukemia. Leukemia & lymphoma. 2006;47(7):1245-52.
• 16. Oberoi S, Lehrnbecher T, Phillips B, Hitzler J, Ethier MC, Beyene J, et al. Leukapheresis and low-dose chemotherapy do not reduce early mortality in acute myeloid leukemia hyperleukocytosis: a systematic review and meta-analysis. Leukemia research. 2014;38(4):460-8.
• 17. Delaunay J, Mazur G, Minden M, Wierzbowska A, Jones MM, Berrak E, et al. Relationship between baseline white blood cell count and renal and hepatic function in older patients with acute myeloid leukemia. Leukemia research reports. 2014;3(1):17-20.
• 18. Medinger M, Passweg JR. Acute myeloid leukaemia genomics. British journal of haematology. 2017;179(4):530-42.
• 19. Zhao BB, Zhu Z, Xu PP, Li JM, Shen ZX, Zhao WL, et al. [Prognostic analysis of non-cytogenetic factors in elderly adults with acute myeloid leukemia]. Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi. 2013;34(1):3-7.
• 20. Le Jeune C, Bertoli S, Elhamri M, Vergez F, Borel C, Huguet F, et al. Initial absolute lymphocyte count as a prognostic factor for outcome in acute myeloid leukemia. Leukemia & lymphoma. 2014;55(4):855-62.
• 21. Gbadamosi B, Ezekwudo D, Bastola S, Jaiyesimi I. Predictive and Prognostic Markers in Adults With Acute Myeloid Leukemia: A Single-Institution Experience. Clinical lymphoma, myeloma & leukemia. 2018;18(7):e287-e94.
• 22. Appelbaum FR, Kopecky KJ, Tallman MS, Slovak ML, Gundacker HM, Kim HT, et al. The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations. British journal of haematology. 2006;135(2):165-73.
• 23. Schoch C, Kern W, Schnittger S, Buchner T, Hiddemann W, Haferlach T. The influence of age on prognosis of de novo acute myeloid leukemia differs according to cytogenetic subgroups. Haematologica. 2004;89(9):1082-90.