Prognostic value of complete remission with superior platelet counts in acute myeloid leukemia

Abhishek Mangaonkar, Hongyan Xu, Jamal Mohsin, Joshua Mansour, Rohini Chintalapally, Ryan Keen, Ashis K. Mondal, David DeRemer, Amber B. Clemmons, Stephen M. Clark, Arpita Shah, Anand Jillela, Ravindra Kolhe, Vamsi Kota

Research output: Contribution to journalArticle

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Abstract

Background Complete remission (CR) in acute myeloid leukemia (AML) is defned as having =5% leukemic blast cells in the bone marrow and return of normal hematopoiesis after the frst induction cycle. There is a subset of patients, however, who achieve reduction of leukemic blast cells with a subnormal platelet count, designated as CR with incomplete platelet recovery (platelet count, >100,000/mcL; normal, 150,000-450,000/mcL), which is associated with inferior outcomes when compared with CR. Furthermore, there is another subset of patients with CR but superior platelet counts (≥400,000/mcL) whose prognostic signifcance is unclear. Objective To establish whether CR with superior platelet counts is associated with better outcomes and can be used as a separate entity for prognostication. Methods A retrospective chart review of 104 cases of AML was conducted. The highest platelet count during days 25-35 from initiation of induction chemotherapy (designated as day 30 platelet count) was documented. A multivariate analysis for other factors such as age, sex, risk categories, day 14+ plasma cell count (average plasma cell percentage at days 14-21), infections, allogeneic bone marrow transplant, and remission status was done. Results Day 30 platelet count was found to be an independent predictor of survival in AML. On the multivariate analysis, the subgroup with superior platelet counts (≥400,000/mcL) was found to be associated with better outcomes. Limitations Results need to be validated in a larger cohort. Conclusions CR with superior platelet recovery (≥400,000/mcL) is a unique subcategory in itself and has prognostic signifcance. This may help better assess response to chemotherapeutic agents and aid in further decision-making regarding treatment.

Original languageEnglish (US)
Pages (from-to)66-71
Number of pages6
JournalJournal of Community and Supportive Oncology
Volume14
Issue number2
DOIs
StatePublished - Feb 2016

Fingerprint

Platelet Count
Acute Myeloid Leukemia
Plasma Cells
Blood Platelets
Multivariate Analysis
Induction Chemotherapy
Hematopoiesis
Bone Marrow Cells
Decision Making
Cell Count
Bone Marrow
Transplants
Survival
Infection

ASJC Scopus subject areas

  • Hematology
  • Oncology

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Prognostic value of complete remission with superior platelet counts in acute myeloid leukemia. / Mangaonkar, Abhishek; Xu, Hongyan; Mohsin, Jamal; Mansour, Joshua; Chintalapally, Rohini; Keen, Ryan; Mondal, Ashis K.; DeRemer, David; Clemmons, Amber B.; Clark, Stephen M.; Shah, Arpita; Jillela, Anand; Kolhe, Ravindra; Kota, Vamsi.

In: Journal of Community and Supportive Oncology, Vol. 14, No. 2, 02.2016, p. 66-71.

Research output: Contribution to journalArticle

Mangaonkar, A, Xu, H, Mohsin, J, Mansour, J, Chintalapally, R, Keen, R, Mondal, AK, DeRemer, D, Clemmons, AB, Clark, SM, Shah, A, Jillela, A, Kolhe, R & Kota, V 2016, 'Prognostic value of complete remission with superior platelet counts in acute myeloid leukemia', Journal of Community and Supportive Oncology, vol. 14, no. 2, pp. 66-71. https://doi.org/10.12788/jcso.0231
Mangaonkar, Abhishek ; Xu, Hongyan ; Mohsin, Jamal ; Mansour, Joshua ; Chintalapally, Rohini ; Keen, Ryan ; Mondal, Ashis K. ; DeRemer, David ; Clemmons, Amber B. ; Clark, Stephen M. ; Shah, Arpita ; Jillela, Anand ; Kolhe, Ravindra ; Kota, Vamsi. / Prognostic value of complete remission with superior platelet counts in acute myeloid leukemia. In: Journal of Community and Supportive Oncology. 2016 ; Vol. 14, No. 2. pp. 66-71.
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abstract = "Background Complete remission (CR) in acute myeloid leukemia (AML) is defned as having =5{\%} leukemic blast cells in the bone marrow and return of normal hematopoiesis after the frst induction cycle. There is a subset of patients, however, who achieve reduction of leukemic blast cells with a subnormal platelet count, designated as CR with incomplete platelet recovery (platelet count, >100,000/mcL; normal, 150,000-450,000/mcL), which is associated with inferior outcomes when compared with CR. Furthermore, there is another subset of patients with CR but superior platelet counts (≥400,000/mcL) whose prognostic signifcance is unclear. Objective To establish whether CR with superior platelet counts is associated with better outcomes and can be used as a separate entity for prognostication. Methods A retrospective chart review of 104 cases of AML was conducted. The highest platelet count during days 25-35 from initiation of induction chemotherapy (designated as day 30 platelet count) was documented. A multivariate analysis for other factors such as age, sex, risk categories, day 14+ plasma cell count (average plasma cell percentage at days 14-21), infections, allogeneic bone marrow transplant, and remission status was done. Results Day 30 platelet count was found to be an independent predictor of survival in AML. On the multivariate analysis, the subgroup with superior platelet counts (≥400,000/mcL) was found to be associated with better outcomes. Limitations Results need to be validated in a larger cohort. Conclusions CR with superior platelet recovery (≥400,000/mcL) is a unique subcategory in itself and has prognostic signifcance. This may help better assess response to chemotherapeutic agents and aid in further decision-making regarding treatment.",
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T1 - Prognostic value of complete remission with superior platelet counts in acute myeloid leukemia

AU - Mangaonkar, Abhishek

AU - Xu, Hongyan

AU - Mohsin, Jamal

AU - Mansour, Joshua

AU - Chintalapally, Rohini

AU - Keen, Ryan

AU - Mondal, Ashis K.

AU - DeRemer, David

AU - Clemmons, Amber B.

AU - Clark, Stephen M.

AU - Shah, Arpita

AU - Jillela, Anand

AU - Kolhe, Ravindra

AU - Kota, Vamsi

PY - 2016/2

Y1 - 2016/2

N2 - Background Complete remission (CR) in acute myeloid leukemia (AML) is defned as having =5% leukemic blast cells in the bone marrow and return of normal hematopoiesis after the frst induction cycle. There is a subset of patients, however, who achieve reduction of leukemic blast cells with a subnormal platelet count, designated as CR with incomplete platelet recovery (platelet count, >100,000/mcL; normal, 150,000-450,000/mcL), which is associated with inferior outcomes when compared with CR. Furthermore, there is another subset of patients with CR but superior platelet counts (≥400,000/mcL) whose prognostic signifcance is unclear. Objective To establish whether CR with superior platelet counts is associated with better outcomes and can be used as a separate entity for prognostication. Methods A retrospective chart review of 104 cases of AML was conducted. The highest platelet count during days 25-35 from initiation of induction chemotherapy (designated as day 30 platelet count) was documented. A multivariate analysis for other factors such as age, sex, risk categories, day 14+ plasma cell count (average plasma cell percentage at days 14-21), infections, allogeneic bone marrow transplant, and remission status was done. Results Day 30 platelet count was found to be an independent predictor of survival in AML. On the multivariate analysis, the subgroup with superior platelet counts (≥400,000/mcL) was found to be associated with better outcomes. Limitations Results need to be validated in a larger cohort. Conclusions CR with superior platelet recovery (≥400,000/mcL) is a unique subcategory in itself and has prognostic signifcance. This may help better assess response to chemotherapeutic agents and aid in further decision-making regarding treatment.

AB - Background Complete remission (CR) in acute myeloid leukemia (AML) is defned as having =5% leukemic blast cells in the bone marrow and return of normal hematopoiesis after the frst induction cycle. There is a subset of patients, however, who achieve reduction of leukemic blast cells with a subnormal platelet count, designated as CR with incomplete platelet recovery (platelet count, >100,000/mcL; normal, 150,000-450,000/mcL), which is associated with inferior outcomes when compared with CR. Furthermore, there is another subset of patients with CR but superior platelet counts (≥400,000/mcL) whose prognostic signifcance is unclear. Objective To establish whether CR with superior platelet counts is associated with better outcomes and can be used as a separate entity for prognostication. Methods A retrospective chart review of 104 cases of AML was conducted. The highest platelet count during days 25-35 from initiation of induction chemotherapy (designated as day 30 platelet count) was documented. A multivariate analysis for other factors such as age, sex, risk categories, day 14+ plasma cell count (average plasma cell percentage at days 14-21), infections, allogeneic bone marrow transplant, and remission status was done. Results Day 30 platelet count was found to be an independent predictor of survival in AML. On the multivariate analysis, the subgroup with superior platelet counts (≥400,000/mcL) was found to be associated with better outcomes. Limitations Results need to be validated in a larger cohort. Conclusions CR with superior platelet recovery (≥400,000/mcL) is a unique subcategory in itself and has prognostic signifcance. This may help better assess response to chemotherapeutic agents and aid in further decision-making regarding treatment.

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DO - 10.12788/jcso.0231

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