Preliminary Study On The Clinical Features And Prognosis Of Acute Monocytic Leukemia

BackgroundAcute monocytic leukemia(AML-M5)is one of the more common clinical types of acute myeloid leukemia(AML),the pathogenesis of which is still unclear,and the treatment effect of this disease is poor and the prognosis is poor.Due to ethnic differences,the clinical characteristics of AML patients vary significantly across geographic locations.However,the clinical characteristics and the prognosis of AML-M5 patients in our hospital have not been counted.In order to understand the differences in clinical characteristics and factors affecting the prognosis of patients in our hospital and the Cancer Genome Atlas(TCGA)database,this study compares the clinical characteristics and survival time of patients in our hospital with those of patients in the TCGA database,and further analyses the prognostic factors of AML-M5 patients in our hospital.ObjectiveTo explore the main clinical features and prognostic factors of acute monocytic leukemia.MethodsThe clinical data of 59 AML-M5 patients treated in the First Affiliated Hospital of Xinxiang Medical College from January 2014 to January 2019 were retrospectively analyzed,and compared the clinical characteristics and survival time of our patients with those of 22 patients in the TCGA database,and important factors that may affect the prognosis of our patients were analyzed.Results1.Compared to patients in the TCGA database,we had more M5 b subtypes(78.0% vs36.4%,P=0.000);a lower proportion of median bone marrow primitive cells(69% vs83%,P=0.006);fewer NPM1 mutations(25.4% vs 54.5%,P=0.013)and fewer DNMT3 A mutations(8.5% vs 50.0%,P=0.000);no statistically significant differences in age,sex,white blood cell count,platelet count,degree of initial induction of remission,cytogenetics,and prognostic risk stratification(P>0.05).2.No statistically significant differences in OS between our patients treated with chemotherapy alone and those treated with chemotherapy alone in the TCGA database(P=0.379);There was no statistical difference in OS between patients treated with chemotherapy alone and those treated with HSCT in the TCGA database(P=0.251).3.Univariate analysis of our patients showed that age,white blood cell count,degree of initial induction of remission,FLT3-ITD mutation,NPM1 mutation without FLT3-ITD mutation and prognostic risk stratification were significantly associated with prognosis(P<0.05).4.Multivariate analysis of our patients showed that age,white blood cell count,degree of initial induction of remission and prognostic risk stratification were independent risk factors for prognosis(P<0.05).Conclusion1.The clinical characteristics of our patients with acute monocytic leukemia differed from those of patients in the TCGA database.Our patients were predominantly of the M5 b subtype,with a lower proportion of median bone marrow primitive cells and fewer NPM1 mutations and DNMT3 A mutations.There was no significant difference in OS between our patients treated with chemotherapy alone and those treated with chemotherapy alone in the TCGA database.2.The prognosis of AML-M5 was associated with age,white blood cell count,degree of initial induction of remission and prognostic risk stratification.