A 32 year old male is diagnosed of having acute myeloid leukemia. His total WBC count was less than normal initially. Which of the following factor has a bad prognosis in AML?
Prognostic factors of acute myeloid leukemia (AML): Advancing age is associated with a poorer prognosis, in pa because of its influence on the patient's ability to survive induction therapy. The leukemic cells in elderly patients more commonly express the multidrug resistance 1 (MDR1) efflux pump that conveys resistance to natural product-derived agents such as the anthracyclines. Patients with t(15;17) have a very good prognosis, and those with t(8;21) and inv(16) a good prognosis, while those with no cytogenetic abnormality have a moderately orable outcome. Patients with a complex karyotype, t(6;9), inv(3), or -7 have a very poor prognosis. Among patients with hyperleukocytosis (>100,000/L), early central nervous system bleeding and pulmonary leukostasis contribute to poor outcome with initial therapy. Karyotypes include monosomy chromosome 5 or chromosome 7 have 78% of relapse rate. Ref: Wetzler M., Marcucci G., Bloomfield C.D. (2012). Chapter 109. Acute and Chronic Myeloid Leukemia. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
Monosomies of chromosomes
Young age
Patients with t(15;17)
Low WBC count