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Normal Absolute Monocyte Count at the Time of Relapse is Associated with Improved Survival After First Salvage Therapy in Adult Patients with Early Relapsed B-Lineage Acute Lymphoblastic Leukemia

Authors Shi Y, Wang N, Huang Z, Chen R, Huang Y, Zhu Y, Xing C, Liang B, Yu K, Feng J

Received 23 May 2020

Accepted for publication 23 July 2020

Published 10 August 2020 Volume 2020:12 Pages 7097—7105

DOI https://doi.org/10.2147/CMAR.S264194

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Rudolph Navari


Yi-fen Shi,1,* Na Wang,2,* Zi-yang Huang,1 Rong-rong Chen,1 Yi-sha Huang,1 Yi-yi Zhu,1 Chong-yun Xing,1 Bin Liang,1 Kang Yu,1 Jian-hua Feng1,3

1Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, People’s Republic of China; 2Health Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, People’s Republic of China; 3Department of Pediatric Hematology-Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jian-hua Feng; Kang Yu Department of Hematology
The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang 325000, People’s Republic of China
Tel +86 577 55578999 extension 669889
Fax +86 577 55578999
Email wzfjh@126.com; yukang@wzhospital.cn

Background: Peripheral monocytes, a key cell type for innate immunity, have been shown to be associated with survival in various types of hematological malignancies. However, no previous studies regarding the prognostic impact of peripheral absolute monocyte count (AMC) in early relapsed B-lineage acute lymphoblastic leukemia (B-ALL) have been reported.
Methods: Forty-nine cases of early relapsed adult B-ALL were reviewed. The upper (0.80 × 109/L) and lower limits (0.12 × 109/L) of the normal value for AMC were used as cut-off points. Kaplan–Meier curves and Log rank test were used for comparison of overall survival (OS). The univariate and multivariate Cox proportional hazards models were used for investigating the factors associated with OS.
Results: More than half (59.2%) of all patients showed a normal AMC (0.12– 0.80 × 109/L). The median follow-up was 5.3 months from the start of first salvage therapy. Univariate analysis revealed that normal AMC (versus low/high AMC) at the time of relapse was a prognostic factor for improved OS (P = 0.021). On multivariate analysis, normal AMC (versus low/high AMC) at the time of relapse remained an independent prognostic factor for improved OS (hazard ratio = 0.43, P = 0.030).
Conclusion: AMC at the time of relapse, which can be easily derived from routine clinical laboratory testing of complete blood count, might be used as a prognostic marker for survival outcomes in adult patients with early relapsed B-ALL.

Keywords: B-lineage acute lymphoblastic leukemia, early relapse, absolute monocyte count, prognosis, survival

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