Abstract
Introduction. Absolute lymphocyte count (ALC) nowadays is a well known independent prognostic factor of survival in acute lymphoblastic leukemia (ALL): higher counts of ALC in period of induction therapy predict better results. The opposite situation remains with ALC and acute myeloid leukemia. Recent researches showed inverse dependence with higher initial ALC and worse response rate or shorter remission in AML. However, there is still limited data of ALC value in AML patients (pts) after chemotherapy courses. This criterion of prognosis is quite cheap and can be widely used in almost every clinic.
Aims. To explore ALC in de novo AML pts after 1 induction course and compare it with clinical outcomes.
Methods. From March 2016 to March 2017 in hematology department of National Research Center for Hematology in the study included 35 pts with de novo AML. All pts were treated with standard protocol and 1 induction course included cytarabine (100mg/m2 twice/day tag 1-7) and daunorubicine (60mg/m2 tag 1-3). In period on 28th - 40th days (depends of recovery) after therapy we performed blood samples with ALC analysis using Flow Cytometry. Kaplan-Meier method with log-rank test was used for disease free survival (DFS) analysis. 8 pts had resistant leukemia after 1st course and 8 another pts had relapse in short time.
Results. We found out that DFS after 1st course was associated with certain amount of ALC (pic.1). ALC more than 0,8 x109/l predicted poor DFS in contrast with pts of low ACL (<0,8x109/l)(median survival 226 days vs not reached, p=0,03) . Limitation of study was the short follow up period (under 1,5 years). Data had retrospective analysis and there were no standardized methods and time points.
Conclusion. Our findingsidentify ALC after 1st induction course in AML isprobably dysfunctional and may cause worse response to leukemia and short DFS. These studies need further researches in bigger cohort of pts.
No relevant conflicts of interest to declare.
