Hemoglobin Level and Karyotype Status are Independent Prognostic Parameters for Acute Myeloid Leukemia: Pilot Study of 244 Patients

Purpose: Acute myeloid leukemia (AML) is a heterogeneous disease with genetic profiling being the primary prognostic factor. The objective of this study was to examine if routinely acquired parameters may be used to improve the prognosis of AML prognosis. Methods: Karyotyping was performed using bone marrow-derived mononuclear cells of 244 de novo diagnosed AML patients and age, sex, total leukocyte count (TLC), platelet count and hemoglobin (Hb) levels at initial presentation were recorded. The patients were given standard treatment and overall survival (OS) for 1 year and 5 years were recorded. Results: As expected, patients with aberrant karyotype status had poor overall survival. Aneuploidy was strongly associated with poor patient survival; while patients presented with hyperploidy had significantly lower OS at both 1 year and 5 years of time points; hypoploidy was correlated only with poor 1 year OS. Interestingly, 146 patients with Hb levels ≤ 8 g/dl had significantly lower 1 year and 5 years OS compared to 95 patients with Hb levels ≥ 8 g/dl. Combining karyotype status or Hb levels with other parameters did not improve patient prognosis. Conclusion: In summary, our results show that in addition to karyotype status, Hb level is an independent prognostic marker that should also be considered for early identification of patients that may benefit from alternative therapies.