Objective: To analyze the prognostic factors in patients with refractory acute myeloid leukemia, so as to provide theoretical basis for choosing an appropriate chemotherapy.
Methods: This study included 48 patients with refractory acute myeloid leukemia who received two standard DA regimens followed by chemotherapy with median dose of Ara-C and mitoxantrone. The factors such as age, gender, responses to the standard chemotherapy, cytogenetic abnormalities, blast cell counts in the bone marrow, peripheral blood cell counts, extramedullary infiltration exhibition and LDH were examined in light of their respective impact on the patients' survival. Cox regression model was used to analyze the prognostic factors.
Results: The results revealed that the factors such as achievement of the first complete remission after standard induction chemotherapy, the remission duration longer than 6 months, favorable cytogenetic abnormalities, blast cell counts less than 50% in bone marrow, absence of severe anemia, absence of liver or pancreatic enlargement or central nerves system (CNS) leukemia, and LDH less than 360 U/L, all indicated favorable prognosis of the patients. Age, gender, white cell counts in periphery blood or lymphadenopathy were not related to the survival of the patients.
Conclusion: The patients with favorable prognostic factors should receive intensive chemotherapy for prolonged survival; allogeneic bone marrow transplantation should be performed as soon as possible in patients with unfavorable prognostic factors.