Prognostic Factors in Acute Myeloid Leukemia

Certain clinical and laboratory findings in patients with AML are associated with favorable or unfavorable outcomes.

Factor	Favorable	Unfavorable
age	< 45 years	< 2 years; > 60 years
leukemia onset	de novo	preceding myelodysplasia
CNS involvement	absent	present
WBC count	< 25,000 per µL	> 100,000 per µL
DIC	absent	present
LDH	normal	increased
serum albumin	normal	low
FAB type	M3, M4Eo	M5, M6, M7
cytogenetics	t (15;17) inv16 / del (16q) t (8;21) normal	-5 (monosomy 5) del (5q) t (6,9) -7 (monosomy 7) del (7q) +8 (trisomy 8) 11q23 abnormalities 3q21 abnormalities 3q26 abnormalities > 47 chromosomes complex abnormalities
cell markers	CD2 CD19 both CD13 and CD14 negative	CD13 CD14 CD34 >=2 lymphoid markers
HLA-DR	negative	positive
Tdt	absent	present
Auer rods	present	absent
in vitro chromogenic assay	normal growth	autonomous growth
in vitro ara-C triphosphate retention	high	low
in vitro labeling index	high	low
bone marrow fibrosis	absent	present
bone marrow pronormoblasts	rare	numerous
bone marrow eosinophils	present	absent
cytoreduction	rapid	delayed
response to chemotherapy	rapid; single course	delayed or incomplete; multiple courses required
associated medical problems (extreme obesity, diabetes mellitus, chronic renal disease)	absent	present

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