Analysis On Prognosis-related Factors Of Acute Myeloid Leukemia

Objective Acute myeloid leukaemia (AML) is a heterogeneous disease. Various factors such as performance status, age, bone marrow blast percentage, gene expression levels, bone marrow microenvironment and sensitive to chemotherapy could have influences on prognosis of AML patients, but few can be used to predict survival. Here we aimed at assessing the prognostic value of the biological factors in AML of adults.Method A retrospective analysis of 182 patients with first treated AML to assess the relationship between prognostic factors including sex, age, white cell count at diagnosis, immunophenotype, cytogenetics, allo-HSCT and complete remission (CR) after one-course induction and overall survival (OS) as well as event free survival (EFS). Survival date were estimated by the Kaplan-Meier method and compared by the log rank test, differences in response rate were compared between groups using x2-test. Multivariate survival analysis was performed using a Cox regression model.Results1. The median age of 182 patients was 49 (14-80) years old, and the median follow-up was 9.7 (0.5-75.5) months, OS rate of 12 months,24 months,36 months was (47.0±3.7)%, (27.1±3.7)% and (16.4±4.2)%, EFS rate of 12 months,24 months,36 months was (36.0±3.6)%, (25.4±3.7)% and (13.4±4.4)%.2.There were 107 patients (58.2%) achieving CR after one-course induction, partial remission in 13 cases (7.7%), not relieved in 62 cases (34.1%), in addition to 18 cases after 2 times,2 cases after 3 times induction chemotherapy achieved complete remission, 127 cases were finally achieved complete remission (69.8%). Various factors including age≥60 years, CD64 negative, unfavorable cytogenetics and failing to achieve CR after one-course induction were associated with lower total CR.3.Univariate analysis demonstrated that age≥60 years, unfavorable cytogenetics, CD11b expression and failing to achieve CR after one-course induction had poor influence on 3-years OS and EFS, while the 3-years OS and EFS for patients with CD19 expression and CD64 expression and allo-HSCT were better. Multivariate analysis suggested that age, cytogenetics, CD11b, CD64, allo-HSCT and CR after one-course induction were independent prognostic factors for OS, while cytogenetics, CD64, allo-HSCT and CR after one-course induction were of importance for EFS.Conclusions We found that age≥60 years, CD64 negative, unfavorable cytogenetics and failing to achieve CR after one-course induction were associated with lower total CR and EFS. Thus, factors including age, cytogenetics, CDllb, CD64, allo-HSCT and CR after one-course induction were independent prognostic factors for OS, while cytogenetics, CD64, allo-HSCT and CR after one-course induction were also of importance for EFS.