Chronic myeloid leukemia (CML): prognostic factors and survival analysis

Chronic myeloid leukemia (CML): prognostic factors and survival analysis

Author Colleoni, Gisele Wally Braga Autor UNIFESP Google Scholar
Chauffaille, Maria de Lourdes Lopes Ferrari Autor UNIFESP Google Scholar
Moncau, José Eduardo Cajado Autor UNIFESP Google Scholar
Souto, Elizabeth Xisto Autor UNIFESP Google Scholar
Silva, Maria Regina Regis Autor UNIFESP Google Scholar
Kerbauy, José Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The prognostic value of different factors upon diagnosis of CML was analysed in 45 Philadelphia (Ph1)-positive patients. The median survival was 48 months. Univariate analysis showed 5 poor prognostic factors (male sex, under 45 years-old, bone marrow blasts greater than or equal to 10 percent, blood basophils greater than or equal to 6 percent and blood eosinophils greater than or equal to 6 percent) which provided for the development of a clinical staging system: Stage I with none or one factor and a two-year survival rate of 100 percent; Stage II with two or three factors and two-year survival of 72.2 percent; and Stage III with four or five factors and two-year survival of 0 percent (p = 0.00016). Multivariate survival analysis showed that combination of blood basophilia and bone marrow blasts had the strongest predictive relationship to survival time. We conclude that a combination of pretreatment factors identifies different risk subcategories in CML patients and is helpful in assessing the overall prognosis and the treatment approach.

Avaliamos o valor prognóstico de diferentes fatores, ao diagnóstico, em 45 pacientes com LMC Ph1-positivos. A sobrevida mediana foi de 48 meses. A análise univariada identificou 5 fatores associados a pior prognóstico (sexo masculino, idade inferior a 45 anos, blastos na medula óssea maior ou igual a 10 percent, basófilos no sangue periférico maior ou igual a 6 percent e eosinófilos no sangue periférico maior ou igual a 6 percent), originando um sistema de estadiamento: estágio I com zero ou um fator e sobrevida de 100 percent em dois anos; estágio II com dois ou três fatores e sobrevida de 72,2 percent em dois anos; estágio III com 4 ou 5 fatores e sobrevida de 0 percent em dois anos (p = 0.00016). A análise multivariada demonstrou que a basofilia no sangue periférico e os blastos na medula óssea foram os fatores que melhor se correlacionaram com o tempo de sobrevida. Concluímos que a combinaçóo de fatores presentes no diagnóstico permite a identificação de diferentes grupos de risco na LMC, podendo ser útil na determinaçóo do prognóstico e na abordagem terapêutica.
Keywords Chronic Myeloid Leukemia
Philadelphia Chromosome
Prognosis
Language English
Date 1996-02-01
Published in São Paulo Medical Journal. Associação Paulista de Medicina - APM, v. 114, n. 1, p. 1083-1090, 1996.
ISSN 1516-3180 (Sherpa/Romeo)
Publisher Associação Paulista de Medicina - APM
Extent 1083-1090
Origin http://dx.doi.org/10.1590/S1516-31801996000100005
Access rights Open access Open Access
Type Article
SciELO ID S1516-31801996000100005 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/403

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