Absolute Monocyte Count is Superior than Absolute Lymphocyte Count at Day 28 as an Independent Prognostic Factor in Acute Myeloid Leukemia

  • Manar M. IsmailEmail author
  • Nahla A. B. Abdulateef
Original Article


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.


Acute 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.

Ethical Approval

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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Indian Society of Hematology and Blood Transfusion 2018

Authors and Affiliations

  1. 1.Laboratory Medicine Department, Faculty of Applied Medical ScienceUmm Al Qura UniversityAl-Abdya, MakkahKingdom of Saudi Arabia
  2. 2.Laboratory and Blood Bank DepartmentKing Abdullah Medical CityMakkahKingdom of Saudi Arabia
  3. 3.Clinical Pathology Department, National Cancer InstituteCairo UniversityGizaEgypt

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