Short et al evaluated the impact of the day of blast disappearance (DOBD) after starting induction chemotherapy as a prognostic factor for a patient with acute myeloid leukemia (AML). The authors are from the University of Texas MD Anderson Cancer Center, Georgia Institute of Technology, Baylor College of Medicine and Novartis.
Patient selection: acute myeloid leukemia undergoing induction chemotherapy
Primary measure: day of blast disappearance (DOBD), defined as day of induction chemotherapy with no blasts in the differential count of the peripheral blood OR WBC count < 400 per µL (because differential count not performed).
A DOBD > 5 was associated with disease resistance and poor prognosis.
Favorable factors for overall survival:
(1) age < 60 years
(2) de novo type of AML (not secondary or therapy-related)
(3) European LeukemiaNet favorable or intermediate-I
(4) DOBD <= 5
Favorable factors for event-free survival:
(1) hemoglobin >= 10 g/dL
(2) lower white blood cell count (WBC)
(3) bone marrow blasts >= 50%
(4) de novo type of AML (not secondary or therapy-related)
(5) nucleophosmin (NPM1) positive
(6) DOBD <= 5
Favorable factors for complete remission to induction chemotherapy:
(1) de novo type of AML (not secondary or therapy-related)
(2) nucleophosmin (NPM1) positive
(3) DOBD <= 5
