Prognostic Factors, Survival Analysis and Cytogenetic Outcomes in Adult Patients with Acute Myeloid Leukemia: A single Center Results

Abstract

In this study, one hundred patients under 65 years of age, who were diagnosed with acute myeloid leukemia (AML) between June 2008 to December 2015 were evaluated retrospectively. Diagnosis of the patients were based on WHO 2008 acute leukemia diagnosis criteria. One hundred AML patients were anlayzed on the basis of gender, , hemoglobin levels <10 and ≥ 10 g/dL and ECOG performans status < 2 and ≥ 2, blast count in bone marrow (BM) <%30 and ≥%30, auer body presence, cytogenetics, CD56, CD19, CD2, CD7, Tdt expression, morphological types and treatment response. 52% was male and mean age at diagnosis was 49 ± 11.4 (18-62) years. Response to induction therapy; complete response was 53%, non-response was 16% and death during the induction phase was 31%. At the end of the study analyses, 35% of patients was in remission and 65% was dead. A multivariate Cox regression analysis revealed gender (p= 0.038, HR= 0.568, 95% CI: 0.332-0.97), lactate dehydrogenase (LDH) levels (p< 0.0001, HR= 1.00, 95% CI: 1.000-1.001), fibrinogen levels (p=0.003, HR=1.002, 95% CI: 1.001-1.004 ), BM fibrosis (p< 0.0001, HR= 4.098, 95% CI: 2.287-7.345), cytogenetic risk classification (p= 0.056, HR= 1.486, 95% CI: 0.990-2.231), fungal infection (p= 0.002, HR= 0.348, 95% CI: 0.179-0.677) as prognostic factors. Aberrant expression of CD2, CD7, CD19 and CD56 on AML cells were not a poor prognostic factor in this study. Gender, LDH levels, fibrinogen levels, cytogenetic risk classification, presence of fibrosis in BM and fungal infection was found to be independent risk factors on mortality in AML patients.Keywords: Acute myeloid leukemia, cytogenetics, complete remission, prognostic factors, overall survival ÖZET Akut Myeloid Lösemili Erişkin Hastalarda Prognostik Faktörler, Sağkalım Analizi ve Sitogenetik Sonuçlar: Tek Merkez SonuçlarıBu çalışmada, Haziran 2008 ile Aralık 2015 tarihleri arasında akut myeloid lösemi (AML) tanısı konulan, 65 yaş altı yüz hasta retrospektif olarak değerlendirildi. Hastalara 2008 Dünya Sağlık Örgütü (DSÖ) akut lösemi tanı kriterlerine göre akut lösemi tanısı , hemoglobin düzeyleri <10 ve ≥ 10 g/dL ve ECOG performans statüleri < 2 ve ≥ 2, kemik iliği blast sayısı <%30 ve ≥%30 olarak, Auer rod varlığı, sitogenetik sonuçları, CD56, CD19, CD2, CD7, Tdt ekspresyonları, morfolojik tip ve tedavi yanıtları değerlendirildi. Hastaların %52'si erkek olup, ortalama yaşları 49±11,4 (18-62) idi. İndüksiyon kemoterapisine yanıt oranları; %53 tam yanıt, %16 yanıtsız, %31 oranında indüksiyon esnasında ölüm olarak bulundu. Hastaların son durum analizinde %35'i remisyonda olup, %65'i ise kaybedilmiştir. Multivariate Cox regresyon analizine göre prognoz üzerine etkili faktörler; cinsiyet (p= 0.038, HR= 0.568, 95% CI: 0.332-0.97), laktat dehidrogenaz (LDH) düzeyleri (p< 0.0001, HR= 1.00, 95% CI: 1.000-1.001), fibrinjojen düzeyleri (p=0.003, HR= 1.002, 95% CI: 1.001-1.004), kemik iliği fbrozisi (p< 0.0001, HR= 4.098, 95% CI: 2.287-7.345), sitogenetik risk sınıflaması (p= 0.056, HR= 1.486, 95% CI: 0.990-2.231) ve fungal enfeksiyon...

Prognostic Value of Neutrophil to Lymphocyte Ratio in Acute Myeloid Leukemia

“…Arber et al classified the blast ratio as <30% and ≥30% and they did not find any difference for OS in their study [32]. Davutoğlu et al did not find an association between the bone marrow blast ratio and OS in their study [33]. Recurrences in 20.1% of patients were determined in our study and we did not find an association between the blast ratio and both the response to therapy and the OSsimilarly to the results of the latter study.…”