Prognostic factors and predictive models of the different causes of failure in te induction of remission in acute nonlymphoblastic leukemia
Lorenzo, J.I.; Sanz, M.A.; Martín-Aragonés, G.; Rafecas, F.J.; Martínez, J.A.; Sanz, G.; Gomis, F.
Medicina Clinica 90(4): 151-155
1988
ISSN/ISBN: 0025-7753 PMID: 3352348 Document Number: 306293
In a previous study we determined the variables with prognostic influence in the overall response to induction in a series of patients with acute non-lymphoblastic leukemia (ANLL), treated with instensive chemotherapy, by means of conventional multivariate analysis [complete remission (CR) vs non-CR]. In this new analysis of the same series we aimed at identifying the variables that could separately predict the risk of deathy by complications of therapy (DCT) and the risk of resistance to chemotherapy (CR) in the induction of remission in ANLL. To determine their relative prognositic significance, we used a multivariate analysis (multiple linear logistic regression) in a series of 124 patients treated with intensive chemotherapy induction regimens. Age (p < 0.0001) serum LDH levels lower than 300 mU/ml (p < 0.05), reticulocyte count lower than 5 .times. 109/l (p < 0.01), and serum calcium level lower than 9 mg/dl (p < 0.05) were the factors predicting a higher risk of DCT during the induction of remission. On the contrary, the high risk of CR was associated with leukocyte counts higher than 100 .times. 109/l (p < 0.01) a rate of peroxydase-positive blast cells lower than 10 % (p < 0.01), negative alphanaphtil acetatesterase reaction (p < 0.05), serum alkaline phosphatase lower than 100 mU/ml (p < 0.05), and albuminemia lower than 3.5 g/dl (p = 0.05). The multivariate models based on those characteristics provided good adjustment to the series data, suggesting a possible applicability to predict the response to induction in new patients with ANLL. The prediction of the risks of death and resistance could allow the individualization of therapy, and facilitate the design and analysis of new therapeutic schedules.