Early Platelets Elevation after Complete Remission in Favorable- and Intermediate-Risk Acute Myeloid Leukemia Is an Independent Predictor of Favorable Outcomes:a Retrospective Study

Platelet (PLT) recovery after chemotherapy is associated with the prognosis in patients with acute myeloid leukemia (AML); however, its predictive value is yet controversial. A total of 206 de novo non-M3 AMLs treated at the Second Affiliated Hospital of Shanxi Medical University from January 2014 to December 2020 and achieved complete remission (CR) were analyzed in this retrospective study. The overall survival (OS) and relapse-free survival (RFS) were assessed using Kaplan-Meier and Cox regression analyses.According to receiver operating characteristic (ROC) curve analysis, 312×10 ⁹/L was confined as the cutoff of the PLT count, and hence, we divided patients into high PLT group (≥312×10 ⁹/L) and low PLT group (100≤PLT<312×10 ⁹/L). Multivariate analysis revealed that early (we defined the highest PLT count from 28-42 days after induction chemotherapy as early platelet count and called it D28 PLT) high PLT count (≥312×10 ⁹/L) recovery showed favorable RFS (hazard ratio (HR)=0.409, p=0.001) and OS (HR=0.394, p=0.001). The subgroup analysis demonstrated that patients in the favorable- and intermediate-risk (non-adverse-risk ) group with D28 PLT≥312×10 ⁹/L showed better survival outcomes (RFS: HR=0.289, p=0.001; OS: HR=0.266, p<0.001) compared to those with 100≤PLT<312×10 ⁹/L. The current study showed that early high PLT count recovery at CR in non-adverse-riskAMLs is an independent positive predictive factor for survival outcomes.