Prognostic factors of acute myeloid leukemia – prognosis

The likelihood of the emergence and development of resistance in acute myeloid leukemia is most often associated with increased expression of the multidrug resistance gene and, accordingly, beta-glycoprotein.

The prognosis in patients in whom a large amount of beta-glycoprotein is detected on the cells in the onset of the disease or an increased expression of the MDR1 gene is detected is significantly worse.

No clinical study is currently being conducted without an assessment of cytogenetic markers of leukemic cells. Depending on the long-term indicators in patients with various chromosomal abnormalities, three groups of “cytogenetic” prognosis were identified: favorable, moderate, poor. The criteria for assigning chromosomal abnormalities to a particular risk group vary from one clinical study to another.

These discrepancies relate to a number of aberrations, such as inv16, t (10; 11), 7q-, +8, which are often determined in patients with acute myeloid leukemia and a number of researchers are used as criteria for the differentiated treatment of acute myeloid leukemia.

As can be seen from the table, the number of research groups corresponds to the number of definitions given to groups of prognosis depending on the karyotype anomalies. This may be due both to differences in therapy (although it was very intensive in these studies) and to a small number of patients with each specific chromosomal aberration.

The long-term results in the respective forecast groups, despite the differences, largely coincide. This coincidence is explained by the fact that a small number of patients with a particular chromosomal aberration, analyzed in any prognosis group, cannot fundamentally affect the overall results of treatment.

It should be emphasized that the importance of cytogenetic markers in assessing the prognosis of the disease in a patient with acute myeloid leukemia is lost over time.

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