Reading Between the Lines: Complete Blood Count-Derived Parameters as Prognostic Factors in Patients With Newly Diagnosed Acute Myeloid Leukemia.

Abstract

Background: Research proved the prognostic significance of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in some hematological malignancies. This study aimed to analyze the role of pretreatment NLR, LMR, PLR, RDW coefficient of variation (RDW-CV), and RDW standard deviation (RDW-SD) as prognostic markers for acute myeloid leukemia (AML).

Methods: This retrospective cohort study included 204 patients newly diagnosed with AML in the Department of Hematooncology and Bone Marrow Transplantation of the Medical University of Lublin.

Results: In the univariate models, higher RDW-CV and lower LMR predicted a poorer response to induction chemotherapy (odds ratio [OR] = 1.21, 95% confidence interval [CI95] = [1.09-2.36], P < .001; OR = 0.95, CI95 = [0.89-0.99], P = .045, respectively). In the multivariate model, age of diagnosis, ECOG (Performance Status Assessment by Eastern Cooperative Oncology Group) score, cytogenetic risk, NLR, and RDW-CV affected the odds of no response to chemotherapy significantly. The risk of progression was influenced by NLR and RDW-CV in the univariate analysis (hazard ratio [HR] = 1.20, CI95 = [1.09-1.33], P < .001; HR = 1.10, CI95 = [1.04-1.17], P = .002, respectively). In the multivariate settings, cytogenetic risk, leukocyte count, and RDW-CV affected progression free survival (PFS) significantly. Based on univariate models, the risk of death, when overall survival (OS) was taken into account, was influenced by NLR, LMR, and RDW-CV (HR = 1.05, CI95 = [1.00-1.09], P = .034; HR = 0.94, CI95 = [0.89-0.98], P = .010; HR = 1.06, CI95 = [1.01-1.10], P = .014, respectively).

Conclusions: Higher NLR, higher RDW, lower LMR, and possibly lower PLR are poor prognostic factors that may help in the risk stratification of patients with AML.