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Absolute Monocyte and Lymphocyte Counts in AML: Prognostic Significance at the Time of Relapse

By: Justine Landin, PhD
Posted: Wednesday, July 28, 2021

Normal levels of peripheral absolute monocyte count (AMC) combined with normal/high levels of absolute lymphocyte count (ALC) at early relapse may improve prognostic outcomes for acute myeloid leukemia (AML). In particular, patients with early relapsed AML and normal AMC and ALC counts appeared to have significantly better chances of overall survival (34.4%), compared with patients with lower AMC and ALC levels (8.3%).

“The advantage of our findings is that AMC and ALC at the time of relapse could be easily derived from complete blood count used in routine clinical laboratories,” stated Jianhua Feng, MD, PhD, of Wenzhou Medical University, Zhejiang, China, and colleagues. The results of this study were accepted for publication in the journal Cancer Investigation.

Patients with de novo non-M3 AML that were treated for early relapse were retrospectively enrolled (n = 57). The complete blood cell count collected at the time of relapse was used to identify levels of AMC and ALC. Patients were subsequently assigned into groups: low/high AMC and low ALC (group 1), low/high AMC or low ALC (group 2), or normal AMC and normal/high ALC (group 3). Medical records were obtained from the treatment facility to determine whether AMC and ALC levels correlated with clinical prognosis.

There was seemingly no difference between groups 1 and 2 in estimated overall survival rates at a median follow-up of 3.3 months (P = .212). However, the estimated survival rate of patients in group 3 was significantly higher than that of patients in group 1 (P = .041). Significant predictors of overall survival included normal AMC and normal/high ALC levels (P = .034), a duration of first complete remission of less than 6 months (P = .026), and response to a salvage regimen (P < .05).

Disclosure: The study authors reported no conflicts of interest.



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