What are the adverse prognostic factors for relapsed acute myeloid leukemia (AML)?

Updated: May 26, 2020
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Response to third-line therapy is even worse. Giles et al studied 594 patients with AML undergoing second salvage therapy from 1980 to 2004. [98] The patient median age was 50 years. Salvage therapy included allogeneic stem cell transplantation (SCT), standard-dose cytosine arabinoside (ara-C) combinations, high-dose ara-C combinations, non–ara-C combinations, and phase I-II single agents. Overall, 76 patients (13%) achieved CR. The median CR duration was 7 months. The median survival was 1.5 months, and the 1-year survival rate was 8%. A multivariate analysis identified the following 6 independent adverse prognostic factors:

  • First CR duration <6 months
  • Second CR duration <6 months
  • Salvage therapy not including allogeneic SCT
  • Noninversion 16 AML
  • Platelet counts <50 × 10 9/L
  • Leukocytosis >50 × 10 9/L.

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