Peripheral blood blast clearance is an independent prognostic factor for survival and response to acute myeloid leukemia induction chemotherapy

Nicholas J. Short, Christopher B. Benton, Hsiang Chun Chen, Peng Qiu, Lisa Gu, Sherry Pierce, Mark Brandt, Abhishek Maiti, Taejin L. Min, Kiran Naqvi, Alfonso Quintas-Cardama, Marina Konopleva, Tapan Kadia, Jorge Cortes, Guillermo Garcia-Manero, Farhad Ravandi, Elias Jabbour, Hagop Kantarjian, Michael Andreeff

Research output: Contribution to journalArticle

Abstract

In patients with acute myeloid leukemia (AML), rapid reduction of circulating blasts with induction chemotherapy may serve as an in vivo marker of chemosensitivity. We performed a retrospective analysis of 363 patients with untreated AML who received induction chemotherapy in order to determine the relationship between day of blast disappearance (DOBD) and complete remission (CR) rates, event-free survival (EFS), and overall survival (OS). DOBD ≤ 5 vs. >5 was identified as the most discriminating cutoff for OS. DOBD > 5 was observed in 35 patients (9.6%). The CR rate for patients with DOBD ≤ 5 vs. >5 was 74.0 and 28.6%, median EFS was 9.4 and 1.8 months, and median OS was 17.1 and 5.8 months, respectively (P < 0.001 for all). DOBD > 5 was independently associated with a lower CR rate and shorter EFS and OS (P < 0.001 for all). DOBD > 5 retained prognostic significance for EFS and OS when patients were stratified by cytogenetic risk group, de novo vs. secondary or therapy-related AML, European LeukemiaNet-based risk groups, and whether CR was achieved. We propose DOBD > 5 as a simple and early marker of disease resistance that identifies patients with poor prognosis who otherwise may not be identified with existing risk stratification systems. Am. J. Hematol. 91:1221–1226, 2016.

Original languageEnglish (US)
Pages (from-to)1221-1226
Number of pages6
JournalAmerican Journal of Hematology
Volume91
Issue number12
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Fingerprint

Induction Chemotherapy
Acute Myeloid Leukemia
Disease-Free Survival
Survival
Disease Resistance
Cytogenetics

ASJC Scopus subject areas

  • Hematology

Cite this

Peripheral blood blast clearance is an independent prognostic factor for survival and response to acute myeloid leukemia induction chemotherapy. / Short, Nicholas J.; Benton, Christopher B.; Chen, Hsiang Chun; Qiu, Peng; Gu, Lisa; Pierce, Sherry; Brandt, Mark; Maiti, Abhishek; Min, Taejin L.; Naqvi, Kiran; Quintas-Cardama, Alfonso; Konopleva, Marina; Kadia, Tapan; Cortes, Jorge; Garcia-Manero, Guillermo; Ravandi, Farhad; Jabbour, Elias; Kantarjian, Hagop; Andreeff, Michael.

In: American Journal of Hematology, Vol. 91, No. 12, 01.12.2016, p. 1221-1226.

Research output: Contribution to journalArticle

Short, NJ, Benton, CB, Chen, HC, Qiu, P, Gu, L, Pierce, S, Brandt, M, Maiti, A, Min, TL, Naqvi, K, Quintas-Cardama, A, Konopleva, M, Kadia, T, Cortes, J, Garcia-Manero, G, Ravandi, F, Jabbour, E, Kantarjian, H & Andreeff, M 2016, 'Peripheral blood blast clearance is an independent prognostic factor for survival and response to acute myeloid leukemia induction chemotherapy', American Journal of Hematology, vol. 91, no. 12, pp. 1221-1226. https://doi.org/10.1002/ajh.24500
Short, Nicholas J. ; Benton, Christopher B. ; Chen, Hsiang Chun ; Qiu, Peng ; Gu, Lisa ; Pierce, Sherry ; Brandt, Mark ; Maiti, Abhishek ; Min, Taejin L. ; Naqvi, Kiran ; Quintas-Cardama, Alfonso ; Konopleva, Marina ; Kadia, Tapan ; Cortes, Jorge ; Garcia-Manero, Guillermo ; Ravandi, Farhad ; Jabbour, Elias ; Kantarjian, Hagop ; Andreeff, Michael. / Peripheral blood blast clearance is an independent prognostic factor for survival and response to acute myeloid leukemia induction chemotherapy. In: American Journal of Hematology. 2016 ; Vol. 91, No. 12. pp. 1221-1226.
@article{0a0dc4f5f8024bc69ea40c4b0f9fe69a,
title = "Peripheral blood blast clearance is an independent prognostic factor for survival and response to acute myeloid leukemia induction chemotherapy",
abstract = "In patients with acute myeloid leukemia (AML), rapid reduction of circulating blasts with induction chemotherapy may serve as an in vivo marker of chemosensitivity. We performed a retrospective analysis of 363 patients with untreated AML who received induction chemotherapy in order to determine the relationship between day of blast disappearance (DOBD) and complete remission (CR) rates, event-free survival (EFS), and overall survival (OS). DOBD ≤ 5 vs. >5 was identified as the most discriminating cutoff for OS. DOBD > 5 was observed in 35 patients (9.6{\%}). The CR rate for patients with DOBD ≤ 5 vs. >5 was 74.0 and 28.6{\%}, median EFS was 9.4 and 1.8 months, and median OS was 17.1 and 5.8 months, respectively (P < 0.001 for all). DOBD > 5 was independently associated with a lower CR rate and shorter EFS and OS (P < 0.001 for all). DOBD > 5 retained prognostic significance for EFS and OS when patients were stratified by cytogenetic risk group, de novo vs. secondary or therapy-related AML, European LeukemiaNet-based risk groups, and whether CR was achieved. We propose DOBD > 5 as a simple and early marker of disease resistance that identifies patients with poor prognosis who otherwise may not be identified with existing risk stratification systems. Am. J. Hematol. 91:1221–1226, 2016.",
author = "Short, {Nicholas J.} and Benton, {Christopher B.} and Chen, {Hsiang Chun} and Peng Qiu and Lisa Gu and Sherry Pierce and Mark Brandt and Abhishek Maiti and Min, {Taejin L.} and Kiran Naqvi and Alfonso Quintas-Cardama and Marina Konopleva and Tapan Kadia and Jorge Cortes and Guillermo Garcia-Manero and Farhad Ravandi and Elias Jabbour and Hagop Kantarjian and Michael Andreeff",
year = "2016",
month = "12",
day = "1",
doi = "10.1002/ajh.24500",
language = "English (US)",
volume = "91",
pages = "1221--1226",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "Wiley-Liss Inc.",
number = "12",

}

TY - JOUR

T1 - Peripheral blood blast clearance is an independent prognostic factor for survival and response to acute myeloid leukemia induction chemotherapy

AU - Short, Nicholas J.

AU - Benton, Christopher B.

AU - Chen, Hsiang Chun

AU - Qiu, Peng

AU - Gu, Lisa

AU - Pierce, Sherry

AU - Brandt, Mark

AU - Maiti, Abhishek

AU - Min, Taejin L.

AU - Naqvi, Kiran

AU - Quintas-Cardama, Alfonso

AU - Konopleva, Marina

AU - Kadia, Tapan

AU - Cortes, Jorge

AU - Garcia-Manero, Guillermo

AU - Ravandi, Farhad

AU - Jabbour, Elias

AU - Kantarjian, Hagop

AU - Andreeff, Michael

PY - 2016/12/1

Y1 - 2016/12/1

N2 - In patients with acute myeloid leukemia (AML), rapid reduction of circulating blasts with induction chemotherapy may serve as an in vivo marker of chemosensitivity. We performed a retrospective analysis of 363 patients with untreated AML who received induction chemotherapy in order to determine the relationship between day of blast disappearance (DOBD) and complete remission (CR) rates, event-free survival (EFS), and overall survival (OS). DOBD ≤ 5 vs. >5 was identified as the most discriminating cutoff for OS. DOBD > 5 was observed in 35 patients (9.6%). The CR rate for patients with DOBD ≤ 5 vs. >5 was 74.0 and 28.6%, median EFS was 9.4 and 1.8 months, and median OS was 17.1 and 5.8 months, respectively (P < 0.001 for all). DOBD > 5 was independently associated with a lower CR rate and shorter EFS and OS (P < 0.001 for all). DOBD > 5 retained prognostic significance for EFS and OS when patients were stratified by cytogenetic risk group, de novo vs. secondary or therapy-related AML, European LeukemiaNet-based risk groups, and whether CR was achieved. We propose DOBD > 5 as a simple and early marker of disease resistance that identifies patients with poor prognosis who otherwise may not be identified with existing risk stratification systems. Am. J. Hematol. 91:1221–1226, 2016.

AB - In patients with acute myeloid leukemia (AML), rapid reduction of circulating blasts with induction chemotherapy may serve as an in vivo marker of chemosensitivity. We performed a retrospective analysis of 363 patients with untreated AML who received induction chemotherapy in order to determine the relationship between day of blast disappearance (DOBD) and complete remission (CR) rates, event-free survival (EFS), and overall survival (OS). DOBD ≤ 5 vs. >5 was identified as the most discriminating cutoff for OS. DOBD > 5 was observed in 35 patients (9.6%). The CR rate for patients with DOBD ≤ 5 vs. >5 was 74.0 and 28.6%, median EFS was 9.4 and 1.8 months, and median OS was 17.1 and 5.8 months, respectively (P < 0.001 for all). DOBD > 5 was independently associated with a lower CR rate and shorter EFS and OS (P < 0.001 for all). DOBD > 5 retained prognostic significance for EFS and OS when patients were stratified by cytogenetic risk group, de novo vs. secondary or therapy-related AML, European LeukemiaNet-based risk groups, and whether CR was achieved. We propose DOBD > 5 as a simple and early marker of disease resistance that identifies patients with poor prognosis who otherwise may not be identified with existing risk stratification systems. Am. J. Hematol. 91:1221–1226, 2016.

UR - http://www.scopus.com/inward/record.url?scp=84992144612&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992144612&partnerID=8YFLogxK

U2 - 10.1002/ajh.24500

DO - 10.1002/ajh.24500

M3 - Article

C2 - 27474808

AN - SCOPUS:84992144612

VL - 91

SP - 1221

EP - 1226

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 12

ER -