Early peripheral blood blast clearance during induction chemotherapy for acute myeloid leukemia predicts superior relapse-free survival
- 15 December 2007
- journal article
- Published by American Society of Hematology in Blood
- Vol. 110 (13), 4172-4174
- https://doi.org/10.1182/blood-2007-07-104091
Abstract
In childhood acute lymphoblastic leukemia (ALL), a rapid decline of circulating leukemic blasts in response to induction chemotherapy or prednisone is one of the most important prognostic factors, not only for achieving remission but also for relapse-free survival (RFS). However, in acute myeloid leukemia (AML) parameters of chemosensitivity have been restricted mainly to the rapidity of achievement of complete remission (CR) or the assessment of residual leukemic bone marrow blasts during aplasia. We hypothesized that the time to circulating peripheral blood blast clearance, as a potential surrogate for in vivo chemosensitivity, would have prognostic relevance in AML also. In a retrospective analysis of a cohort of 86 adult patients with AML receiving uniform induction and consolidation chemotherapy, we demonstrate that the time to clearance of circulating blasts during induction chemotherapy is an independent prognostic marker of RFS, superseding other known or established risk factors, including karyotype and number of inductions to achieve CR.Keywords
This publication has 8 references indexed in Scilit:
- Influence of new molecular prognostic markers in patients with karyotypically normal acute myeloid leukemia: recent advancesCurrent Opinion in Hematology, 2007
- Cytogenetics and age are major determinants of outcome in intensively treated acute myeloid leukemia patients older than 60 years: results from AMLSG trial AML HD98-BBlood, 2006
- Early blast clearance by remission induction therapy is a major independent prognostic factor for both achievement of complete remission and long-term outcome in acute myeloid leukemia: data from the German AML Cooperative Group (AMLCG) 1992 TrialBlood, 2003
- Effect of time to complete remission on subsequent survival and disease-free survival time in AML, RAEB-t, and RAEBBlood, 2000
- A simple, robust, validated and highly predictive index for the determination of risk‐directed therapy in acute myeloid leukaemia derived from the MRC AML 10 trialBritish Journal of Haematology, 1999
- The Importance of Diagnostic Cytogenetics on Outcome in AML: Analysis of 1,612 Patients Entered Into the MRC AML 10 TrialBlood, 1998
- Cytoreduction and prognosis in childhood acute lymphoblastic leukemia.Journal of Clinical Oncology, 1996
- Prediction of response to chemotherapy in acute myelocytic leukemiaBlood, 1980