Absolute Monocyte Count is Superior than Absolute Lymphocyte Count at Day 28 as an Independent Prognostic Factor in Acute Myeloid Leukemia
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Leukemia is one of leading causes of death despite the significant improvement of survival. This study aimed at assessing the impact of absolute monocytic count (AMC), and absolute lymphocytic count (ALC) recovery on overall survival (OS) and leukemia free survival (LFS) in AML. 83 de novo AML cases were enrolled in this study. The hemogram parameters including differential leukocyte counts were determined and collected sequentially at days 1, 14, 21 and 28. There was no significant difference regarding AMC or ALC at any time points in relation to the cytogenetics prognostic groups. High AMC ≥ 0.8 × 109/L at day 28 was associated with shorter OS and LFS, P value 0.012 and 0.003 respectively. On multivariate models, high AMC was shown as an independent prognostic factor associated with poor OS and LFS (HR 3, 95% CI 1.1–8.1 and P value 0.02) and (HR 5, 95% CI 1.5–17.4 and P value 0.01) respectively. High ALC-D28 (≥ 0.35 × 109/L) was associated with prolonged OS and LFS survival, P value 0.032 and 0.016 respectively. However, it failed to prove the same significance using multivariate analysis. It was concluded that low AMC is an emerging independent predictor of better outcome in AML.
KeywordsAcute myeloid leukemia Absolute monocyte count Absolute lymphocyte count Induction chemotherapy Overall survival Leukemia free survival Prognostic factors
The authors would like to thank Prof. Dr. Manar M. Moneer, professor of medical biostatistics, National Cancer Institute, Cairo University, Egypt for her great support regarding survival analysis.
Compliance with Ethical Standards
Conflict of interest
The authors declare that there is no conflict of interest regarding the publication of this paper.
The study was approved by the Institutional Ethics Committee IRB13-057. All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.
Informed consent was obtained from all individual participants included in the study.
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