Initial absolute monocyte count as an immune biomarker for clinical response in acute myeloid leukemia with monocytic differentiation
Background Absolute monocyte count (AMC) correlates with survival outcomes in various hematologic malignancies. However, its role in myeloid malignancies including AML needs to be highlighted. So, this prospective cohort study aimed to assess the effect of AMC on the treatment outcome and survival i...
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| Veröffentlicht in: | Journal of Egyptian National Cancer Institute 2020-08, Vol.32 (1), p.1-11, Article 33 |
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| description | Background
Absolute monocyte count (AMC) correlates with survival outcomes in various hematologic malignancies. However, its role in myeloid malignancies including AML needs to be highlighted. So, this prospective cohort study aimed to assess the effect of AMC on the treatment outcome and survival in a 56 adult de novo AML patients with monocytic differentiation, admitted to the Clinical Hematology Unit, Internal Medicine Department, in a tertiary referral hospital in Egypt, from July 2016 to June 2019.
Results
The initial AMC was measured either by manual differential or the hematology automatic analyzer Sysmex XN-2000 and patients were classified by using receiver operating characteristic curve into two groups monocytopenic (≤ 4 × 10
9
/L) and non-monocytopenic (> 4 × 10
9
/L) group; including 24 (42.9%) and 32 (57.1%) patients, respectively. After a median follow up period of 7.7 (range 0.5–33.2) months, the monocytopenic group was associated with a significantly higher CR rate (
P
= 0.019), with a lower death as well as relapse and early relapse rates (
P
= 0.011, 0.033, and 0.002, respectively). Moreover, low initial AMC along with intensive induction were independently associated with complete response to induction chemotherapy with HR, 5.04 [1.37–18.58],
P
= 0.015, and 5.67 [1.48–21.71],
P
= 0.011, respectively by using the multivariate logistic regression model. Regarding survival, the monocytopenic group was associated with a better 3-year disease-free survival rate (
P
= 0.011) in univariate Cox regression only but did not reach significance in the multivariate model and did not affect the overall survival as well.
Conclusion
Initial AMC was found to be an independent prognostic immune biomarker for treatment response in AML patients with monocytic differentiation. However, it did not appear as an independent predictor of survival in a multivariate analysis.
Graphical abstract |
| doi_str_mv | 10.1186/s43046-020-00044-2 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_doaj_</sourceid><recordid>TN_cdi_proquest_journals_2729538240</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A680085116</galeid><doaj_id>oai_doaj_org_article_c06499f1d5a24dd6888982543c7781ed</doaj_id><sourcerecordid>A680085116</sourcerecordid><originalsourceid>FETCH-LOGICAL-c529t-ec436b1166a28172fc8b67bf8324433aac0a8e9e1248d3e718350e74c8fa235e3</originalsourceid><addsrcrecordid>eNp9Uk2LFDEUbETBdfUPeAp47jVfnU4fl8WPgYW9rOfwOnkZM9udjEk3Mj_A_22cVldBJIc8HlWVqlBN85rRK8a0elukoFK1lNOWUiply580F7zTQ0slHZ7-MT9vXpRyoFQp2ncXzbddDEuAicBY0rQuSOYUkz3VwaY1LgQKgUjCPK8RyRjSDPkBM_EpEzuFGGzlZizHFAuSEAnYs8gJpxQcmXB9wDkA-RqWz7-kgyUueI8ZY316CSm-bJ55mAq--nlfNp_ev7u_-dje3n3Y3Vzftrbjw9KilUKNjCkFXLOee6tH1Y9eCy6lEACWgsYBGZfaCeyZFh3FXlrtgYsOxWWz23RdgoM55lDTnEyCYM6LlPcGcvU3obFUyWHwzHXApXNKaz1o3klh-14zdFXrzaZ1zOnLimUxh7TmWO0b3vOhE5pL-ojaQxUN0aclg51DseZaaUp1V-NU1NU_UPW4-nk2RfSh7v8i8I1gcyolo_8dhlHzoxFma4SpjTDnRhheSWIjlQqOe8yPjv_D-g6ua7jt</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2729538240</pqid></control><display><type>article</type><title>Initial absolute monocyte count as an immune biomarker for clinical response in acute myeloid leukemia with monocytic differentiation</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Springer Nature OA/Free Journals</source><creator>Embaby, Ahmed ; Fathy, Ayman ; Al-Akkad, Mohammad ; Baraka, Ahmad ; Ibrahim, Taiseer ; Zidan, Nahla ; Refaat, Mohamed ; Elsheikh, Haitham</creator><creatorcontrib>Embaby, Ahmed ; Fathy, Ayman ; Al-Akkad, Mohammad ; Baraka, Ahmad ; Ibrahim, Taiseer ; Zidan, Nahla ; Refaat, Mohamed ; Elsheikh, Haitham</creatorcontrib><description>Background
Absolute monocyte count (AMC) correlates with survival outcomes in various hematologic malignancies. However, its role in myeloid malignancies including AML needs to be highlighted. So, this prospective cohort study aimed to assess the effect of AMC on the treatment outcome and survival in a 56 adult de novo AML patients with monocytic differentiation, admitted to the Clinical Hematology Unit, Internal Medicine Department, in a tertiary referral hospital in Egypt, from July 2016 to June 2019.
Results
The initial AMC was measured either by manual differential or the hematology automatic analyzer Sysmex XN-2000 and patients were classified by using receiver operating characteristic curve into two groups monocytopenic (≤ 4 × 10
9
/L) and non-monocytopenic (> 4 × 10
9
/L) group; including 24 (42.9%) and 32 (57.1%) patients, respectively. After a median follow up period of 7.7 (range 0.5–33.2) months, the monocytopenic group was associated with a significantly higher CR rate (
P
= 0.019), with a lower death as well as relapse and early relapse rates (
P
= 0.011, 0.033, and 0.002, respectively). Moreover, low initial AMC along with intensive induction were independently associated with complete response to induction chemotherapy with HR, 5.04 [1.37–18.58],
P
= 0.015, and 5.67 [1.48–21.71],
P
= 0.011, respectively by using the multivariate logistic regression model. Regarding survival, the monocytopenic group was associated with a better 3-year disease-free survival rate (
P
= 0.011) in univariate Cox regression only but did not reach significance in the multivariate model and did not affect the overall survival as well.
Conclusion
Initial AMC was found to be an independent prognostic immune biomarker for treatment response in AML patients with monocytic differentiation. However, it did not appear as an independent predictor of survival in a multivariate analysis.
Graphical abstract</description><identifier>ISSN: 2589-0409</identifier><identifier>ISSN: 1110-0362</identifier><identifier>EISSN: 2589-0409</identifier><identifier>DOI: 10.1186/s43046-020-00044-2</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Absolute monocyte count ; Acute myeloid leukemia ; Age ; Bone marrow ; Cancer ; Chemotherapy ; Hematology ; Hemoglobin ; Immune biomarker ; Immune response ; Laboratories ; Leukemia ; Medicine ; Medicine & Public Health ; Monocytic differentiation ; Oncology ; Remission (Medicine) ; Response ; Survival analysis</subject><ispartof>Journal of Egyptian National Cancer Institute, 2020-08, Vol.32 (1), p.1-11, Article 33</ispartof><rights>The Author(s) 2020</rights><rights>COPYRIGHT 2020 Springer</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c529t-ec436b1166a28172fc8b67bf8324433aac0a8e9e1248d3e718350e74c8fa235e3</citedby><cites>FETCH-LOGICAL-c529t-ec436b1166a28172fc8b67bf8324433aac0a8e9e1248d3e718350e74c8fa235e3</cites><orcidid>0000-0002-9078-0463</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,862,27911,27912</link.rule.ids></links><search><creatorcontrib>Embaby, Ahmed</creatorcontrib><creatorcontrib>Fathy, Ayman</creatorcontrib><creatorcontrib>Al-Akkad, Mohammad</creatorcontrib><creatorcontrib>Baraka, Ahmad</creatorcontrib><creatorcontrib>Ibrahim, Taiseer</creatorcontrib><creatorcontrib>Zidan, Nahla</creatorcontrib><creatorcontrib>Refaat, Mohamed</creatorcontrib><creatorcontrib>Elsheikh, Haitham</creatorcontrib><title>Initial absolute monocyte count as an immune biomarker for clinical response in acute myeloid leukemia with monocytic differentiation</title><title>Journal of Egyptian National Cancer Institute</title><addtitle>J Egypt Natl Canc Inst</addtitle><description>Background
Absolute monocyte count (AMC) correlates with survival outcomes in various hematologic malignancies. However, its role in myeloid malignancies including AML needs to be highlighted. So, this prospective cohort study aimed to assess the effect of AMC on the treatment outcome and survival in a 56 adult de novo AML patients with monocytic differentiation, admitted to the Clinical Hematology Unit, Internal Medicine Department, in a tertiary referral hospital in Egypt, from July 2016 to June 2019.
Results
The initial AMC was measured either by manual differential or the hematology automatic analyzer Sysmex XN-2000 and patients were classified by using receiver operating characteristic curve into two groups monocytopenic (≤ 4 × 10
9
/L) and non-monocytopenic (> 4 × 10
9
/L) group; including 24 (42.9%) and 32 (57.1%) patients, respectively. After a median follow up period of 7.7 (range 0.5–33.2) months, the monocytopenic group was associated with a significantly higher CR rate (
P
= 0.019), with a lower death as well as relapse and early relapse rates (
P
= 0.011, 0.033, and 0.002, respectively). Moreover, low initial AMC along with intensive induction were independently associated with complete response to induction chemotherapy with HR, 5.04 [1.37–18.58],
P
= 0.015, and 5.67 [1.48–21.71],
P
= 0.011, respectively by using the multivariate logistic regression model. Regarding survival, the monocytopenic group was associated with a better 3-year disease-free survival rate (
P
= 0.011) in univariate Cox regression only but did not reach significance in the multivariate model and did not affect the overall survival as well.
Conclusion
Initial AMC was found to be an independent prognostic immune biomarker for treatment response in AML patients with monocytic differentiation. However, it did not appear as an independent predictor of survival in a multivariate analysis.
Graphical abstract</description><subject>Absolute monocyte count</subject><subject>Acute myeloid leukemia</subject><subject>Age</subject><subject>Bone marrow</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Hematology</subject><subject>Hemoglobin</subject><subject>Immune biomarker</subject><subject>Immune response</subject><subject>Laboratories</subject><subject>Leukemia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Monocytic differentiation</subject><subject>Oncology</subject><subject>Remission (Medicine)</subject><subject>Response</subject><subject>Survival analysis</subject><issn>2589-0409</issn><issn>1110-0362</issn><issn>2589-0409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNp9Uk2LFDEUbETBdfUPeAp47jVfnU4fl8WPgYW9rOfwOnkZM9udjEk3Mj_A_22cVldBJIc8HlWVqlBN85rRK8a0elukoFK1lNOWUiply580F7zTQ0slHZ7-MT9vXpRyoFQp2ncXzbddDEuAicBY0rQuSOYUkz3VwaY1LgQKgUjCPK8RyRjSDPkBM_EpEzuFGGzlZizHFAuSEAnYs8gJpxQcmXB9wDkA-RqWz7-kgyUueI8ZY316CSm-bJ55mAq--nlfNp_ev7u_-dje3n3Y3Vzftrbjw9KilUKNjCkFXLOee6tH1Y9eCy6lEACWgsYBGZfaCeyZFh3FXlrtgYsOxWWz23RdgoM55lDTnEyCYM6LlPcGcvU3obFUyWHwzHXApXNKaz1o3klh-14zdFXrzaZ1zOnLimUxh7TmWO0b3vOhE5pL-ojaQxUN0aclg51DseZaaUp1V-NU1NU_UPW4-nk2RfSh7v8i8I1gcyolo_8dhlHzoxFma4SpjTDnRhheSWIjlQqOe8yPjv_D-g6ua7jt</recordid><startdate>20200803</startdate><enddate>20200803</enddate><creator>Embaby, Ahmed</creator><creator>Fathy, Ayman</creator><creator>Al-Akkad, Mohammad</creator><creator>Baraka, Ahmad</creator><creator>Ibrahim, Taiseer</creator><creator>Zidan, Nahla</creator><creator>Refaat, Mohamed</creator><creator>Elsheikh, Haitham</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><general>SpringerOpen</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-9078-0463</orcidid></search><sort><creationdate>20200803</creationdate><title>Initial absolute monocyte count as an immune biomarker for clinical response in acute myeloid leukemia with monocytic differentiation</title><author>Embaby, Ahmed ; Fathy, Ayman ; Al-Akkad, Mohammad ; Baraka, Ahmad ; Ibrahim, Taiseer ; Zidan, Nahla ; Refaat, Mohamed ; Elsheikh, Haitham</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c529t-ec436b1166a28172fc8b67bf8324433aac0a8e9e1248d3e718350e74c8fa235e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Absolute monocyte count</topic><topic>Acute myeloid leukemia</topic><topic>Age</topic><topic>Bone marrow</topic><topic>Cancer</topic><topic>Chemotherapy</topic><topic>Hematology</topic><topic>Hemoglobin</topic><topic>Immune biomarker</topic><topic>Immune response</topic><topic>Laboratories</topic><topic>Leukemia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Monocytic differentiation</topic><topic>Oncology</topic><topic>Remission (Medicine)</topic><topic>Response</topic><topic>Survival analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Embaby, Ahmed</creatorcontrib><creatorcontrib>Fathy, Ayman</creatorcontrib><creatorcontrib>Al-Akkad, Mohammad</creatorcontrib><creatorcontrib>Baraka, Ahmad</creatorcontrib><creatorcontrib>Ibrahim, Taiseer</creatorcontrib><creatorcontrib>Zidan, Nahla</creatorcontrib><creatorcontrib>Refaat, Mohamed</creatorcontrib><creatorcontrib>Elsheikh, Haitham</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of Egyptian National Cancer Institute</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Embaby, Ahmed</au><au>Fathy, Ayman</au><au>Al-Akkad, Mohammad</au><au>Baraka, Ahmad</au><au>Ibrahim, Taiseer</au><au>Zidan, Nahla</au><au>Refaat, Mohamed</au><au>Elsheikh, Haitham</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Initial absolute monocyte count as an immune biomarker for clinical response in acute myeloid leukemia with monocytic differentiation</atitle><jtitle>Journal of Egyptian National Cancer Institute</jtitle><stitle>J Egypt Natl Canc Inst</stitle><date>2020-08-03</date><risdate>2020</risdate><volume>32</volume><issue>1</issue><spage>1</spage><epage>11</epage><pages>1-11</pages><artnum>33</artnum><issn>2589-0409</issn><issn>1110-0362</issn><eissn>2589-0409</eissn><abstract>Background
Absolute monocyte count (AMC) correlates with survival outcomes in various hematologic malignancies. However, its role in myeloid malignancies including AML needs to be highlighted. So, this prospective cohort study aimed to assess the effect of AMC on the treatment outcome and survival in a 56 adult de novo AML patients with monocytic differentiation, admitted to the Clinical Hematology Unit, Internal Medicine Department, in a tertiary referral hospital in Egypt, from July 2016 to June 2019.
Results
The initial AMC was measured either by manual differential or the hematology automatic analyzer Sysmex XN-2000 and patients were classified by using receiver operating characteristic curve into two groups monocytopenic (≤ 4 × 10
9
/L) and non-monocytopenic (> 4 × 10
9
/L) group; including 24 (42.9%) and 32 (57.1%) patients, respectively. After a median follow up period of 7.7 (range 0.5–33.2) months, the monocytopenic group was associated with a significantly higher CR rate (
P
= 0.019), with a lower death as well as relapse and early relapse rates (
P
= 0.011, 0.033, and 0.002, respectively). Moreover, low initial AMC along with intensive induction were independently associated with complete response to induction chemotherapy with HR, 5.04 [1.37–18.58],
P
= 0.015, and 5.67 [1.48–21.71],
P
= 0.011, respectively by using the multivariate logistic regression model. Regarding survival, the monocytopenic group was associated with a better 3-year disease-free survival rate (
P
= 0.011) in univariate Cox regression only but did not reach significance in the multivariate model and did not affect the overall survival as well.
Conclusion
Initial AMC was found to be an independent prognostic immune biomarker for treatment response in AML patients with monocytic differentiation. However, it did not appear as an independent predictor of survival in a multivariate analysis.
Graphical abstract</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1186/s43046-020-00044-2</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-9078-0463</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Springer Nature OA/Free Journals |
| subjects | Absolute monocyte count Acute myeloid leukemia Age Bone marrow Cancer Chemotherapy Hematology Hemoglobin Immune biomarker Immune response Laboratories Leukemia Medicine Medicine & Public Health Monocytic differentiation Oncology Remission (Medicine) Response Survival analysis |
| title | Initial absolute monocyte count as an immune biomarker for clinical response in acute myeloid leukemia with monocytic differentiation |
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