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Background  Risk stratification and prognosis prediction of acute myeloid leukemia (AML) are largely dependent on pre-treatment information. However, post-treatment data also provides much useful information. In this retrospective study, we explored whether the level of blood count recovery before and after the first minimal residual disease (MRD) negative complete remission (CR) is relevant to clinical outcomes of AML patients.    Methods  For each included patient, peripheral platelet counts were measured on the day before initial treatment (PLT pre ), whereas platelet peak values (PLT peak ) were recorded after marrow recovery following the chemotherapy course inducing the first MRD-negative CR. The difference (D PLT ) between these two values (D PLT  = PLT peak− PLT pre ) was calculated. X-tile software was utilized to establish the optimal cut-point for D PLT , which was expected to distinguish CR patients with different clinical outcomes. A cross validation analysis was conducted to confirm the robustness of the established cut-point. The results were further tested by a Cox multivariate analysis.    Results  The optimal cut-point of D PLT  was determined as 212 × 10 9 /L. Patients in high D PLT  group were observed to have a significantly better PFS ( p  = 0.016) and a better OS (without statistical significance,  p  = 0.106). Cox multivariate analysis showed that higher D PLT  was associated with longer PFS (HR = 2.894, 95% CI: 1.320–6.345,  p  = 0.008) and longer OS (HR = 3.077, 95% CI: 1.130–8.376,  p  = 0.028).    Conclusion  Platelet recovery degree before and after achieving MRD-negative CR (D PLT ) is a potential predictor of clinical outcomes in CR patients. Higher D PLT  value is associated with longer PFS and OS. Our findings may help to develop simple methods for AML prognosis evaluation.

bmc cancer

Prognostic value of platelet recovery degree before and after achieving minimal residual disease negative complete remission in acute myeloid leukemia patients