Platelet production and related pathophysiology in acute myelogenous leukemia at first diagnosis: Prognostic implications

Trafalis, Dimitrios T.; Poulakidas, Elias; Kapsimali, V.; Tsigris, Christos; Papanicolaou, Xenofon; Harhalakis, Nikolaos; Nikiforakis, Emmanuel; Mentzikof-Mitsouli, Chrisanthi

doi:10.3892/or.19.4.1021

Cited by 6 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We further noted that these effects were more profound in intermediate-risk patients than favorable and adverse-risk AML patients. These findings were consistent with other investigations that lower PLT count predicted better survival in intermediate-risk group [ 24 , 32 ]. Moreover, hyperleukocytosis defined as WBC > 100 × 10 9 /L at diagnosis was demonstrated to relate with increasing early mortality in AML patients [ 10 , 33 ], which prognostic significance in RFS is not widely recognized [ 34 , 35 ].…”

Section: Discussionsupporting

confidence: 93%

“…Some research showed that AML patients with medium PLT count at diagnosis in the range of 50–120 × 10 9 /L had longer OS and DFS than the other patients [ 24 ]. Others reported that pretreatment PLT count > 130 × 10 9 /L was an unfavorable prognostic factor for chemotherapy response and prognosis in AML patients [ 32 ]. Although cut-off value of PLT count was various in different studies, these clinical data demonstrated that higher PLT count harbored a negative impact on survival of AML patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Influence on therapeutic outcome of platelet count at diagnosis in patients with de novo non-APL acute myeloid leukemia

Zhang,

Wu,

Yuan

et al. 2023

BMC Cancer

View full text Add to dashboard Cite

Background Platelet (PLT) count at diagnosis plays an important role in cancer development and progression in solid tumors. However, it remains controversial whether PLT count at diagnosis influences therapeutic outcome in patients with non-acute promyelocytic leukemia (APL) acute myeloid leukemia (AML). Methods This study analyzed the relationship between PLT count at diagnosis and genetic mutations in a cohort of 330 newly diagnosed non-APL AML patients. The impact of PLT count on complete remission, minimal residual disease status and relapse-free survival (RFS) were evaluated after chemotherapy or allogeneic hematopoietic stem cell transplantation (allo-HSCT). Results Our studies showed that patients with DNMT3A mutations have a higher PLT count at diagnosis, while patients with CEBPA biallelic mutations or t(8;21)(q22; q22) translocation had lower PLT count at diagnosis. Furthermore, non-APL AML patients with high platelet count (> 65 × 109/L) at diagnosis had worse response to induction chemotherapy and RFS than those with low PLT count. In addition, allo-HSCT could not absolutely attenuated the negative impact of high PLT count on the survival of non-APL AML patients. Conclusion PLT count at diagnosis has a predictive value for therapeutic outcome for non-APL AML patients.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Influence on therapeutic outcome of platelet count at diagnosis in patients with de novo non-APL acute myeloid leukemia

Zhang,

Wu,

Yuan

et al. 2023

BMC Cancer

View full text Add to dashboard Cite

show abstract

“…Dimitrios indicated that group 3 (pretreatment PLT counts of > 130 × 10 9 /L) had the worst prognosis compared with group 1 (pretreatment PLT count of < 25 × 10 9 /L) and group 2 (pretreatment PLT counts 25–130 × 10 9 /L); group 3 had favorable prognostic features, high levels of endogenous thrombopoietin (TPO), and high expression of TPO receptor (C-MPL), but with low chemotherapy response and poor prognosis [ 18 ]. The TPO/MPL regulatory pathway plays a critical role in the interaction of human leukemic stem cells (LSCs) with the hematopoietic microenvironment; the upregulation of the TPO/c-MPL signaling pathway may protect the LSCs from the effects of chemotherapy as treatment for AML and is associated with chemoresistance and AML recurrence [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Dynamic trajectory of platelet counts after the first cycle of induction chemotherapy in AML patients

Wang

Feng

et al. 2022

BMC Cancer

View full text Add to dashboard Cite

Background Platelet counts varied over time after induction chemotherapy. We aimed to investigate the different trajectories of platelet counts after the first cycle of induction chemotherapy in patients newly diagnosed with acute myeloid leukemia. Methods and results In total, 149 individuals were included in this study. We identified four distinct trajectories using a group-based trajectory model: low- stability group (n = 27, 18.12%), low-level decrease–medium elevation group (n = 42, 28.19%), low-level decrease–high elevation group (n = 60, 40.27%), and high-level decrease–medium elevation group (n = 20, 13.42%). The baseline characteristics of the high-level decrease–medium elevation group included higher platelet count, lower white blood cell count, lower percentage of bone marrow blasts, and lower rates of complete remission after the first cycle of induction chemotherapy. Compared with the low-stability group, the hazard ratios were 0.32 (95% confidence interval, 0.15–0.68) for the low-level decrease–medium elevation group, 0.31 (95% confidence interval, 0.15–0.63) for the low-level decrease–high elevation group, and 0.35 (95% confidence interval, 0.13–0.89) for the high-level decrease–medium elevation group after adjustment for age and gender by Cox proportional hazard regression. Compared with the low-stability group, the hazard ratios were 0.33 (95% confidence interval, 0.14–0.77) for the low-level decrease–medium elevation group and 0.31 (95% confidence interval, 0.14–0.67) for the low-level decrease–high elevation group after adjustment for age, gender, white blood cell count, and bone marrow blasts. These associations persisted after adjusting for age, gender, white blood cell count, bone marrow blasts, and platelet count. Conclusion The dynamic trajectory of platelet counts after the first cycle of induction chemotherapy is a significant predictor of all-cause mortality in patients with acute myeloid leukemia. Timely intervention should be considered for the low-stability group. The low-level decrease–medium elevation and low-level decrease-high elevation groups were independent protective factors for all-cause mortality.

show abstract

“…In recent years, several studies have shown a negative correlation between platelet count and OS before treatment, which can be used as an independent predictor of AML prognosis [25][26][27][28][29][30] . Other factors related to initial platelets, including rebound thrombocytosis, platelet production, and platelet recovery time after platelet induction chemotherapy, are independent prognostic predictors of AML or acute lymphocytic leukemia (ALL) Index [31][32][33] .…”

Section: Discussionmentioning

confidence: 99%

Effect of MYH10 Variant on Acute Leukemia with Low Platelet Count Prognosis

Xiao¹,

Lin²,

Lin³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Acute myeloid leukemia (AML) is a blood disorder characterized by abnormal white blood cell count, anemia, or abnormal platelet count. It is associated with molecular genetic changes. While platelet counts vary at first diagnosis，platelets recover after chemotherapy. Objectives:This study aimed to; (1) Investigate whether the platelet count and genotype at first diagnosis are related to chemotherapy and their significance on chemotherapy prognosis; (2) Determine whether newly diagnosed patients with low platelet count have a poor prognosis and if it can be used as a separate prognostic predictor; (3) Determine whether the mutation genotype affects platelet count and its prognosis at first diagnosis. Methods: A retrospective chart review of 301 AML patients was conducted. Univariate, multivariate unconditional Logistic regression and Cox regression analyses were also conducted. Bioinformatics technology was used to extract the GSE12662 data set from the GEO database to analyze differentially expressed genes in AML patients. Besides, biological functions, pathways, proteins, and prognosis were assessed. Conclusion: Increased platelet count in AML patients after chemotherapy was an independent risk factor affecting complete remission. The platelet count also had some guiding significance for evaluating the sensitivity of patients to chemotherapy. MYH10 causes thrombocytopenia in acute myeloid leukemia via RUNX1 gene alteration and influence of prognostic factors. MYH10 variant detection improves the identification of AML molecular characteristics and its prognostic impact on AML, helping in the response analysis to chemotherapeutic agents and further treatment decisions.

show abstract

Platelet production and related pathophysiology in acute myelogenous leukemia at first diagnosis: Prognostic implications

Cited by 6 publications

References 23 publications

Influence on therapeutic outcome of platelet count at diagnosis in patients with de novo non-APL acute myeloid leukemia

Influence on therapeutic outcome of platelet count at diagnosis in patients with de novo non-APL acute myeloid leukemia

Dynamic trajectory of platelet counts after the first cycle of induction chemotherapy in AML patients

Effect of MYH10 Variant on Acute Leukemia with Low Platelet Count Prognosis

Contact Info

Product

Resources

About