AML prognostic factors

Prognostic fctors in AML

Good	Intermediate risk	Poor
T(8;21) T(15;17) Inv.16 <45 yrs ECOG performance status 0.1 Leukocytosis <25000.mm3 Rapid cytoreduction Auer rods Eosinophilia FAB type M2,M3,M4 CD2+ lymphoid cells	Trisomy 8—m.c. numerical abnormality in AML Trisomy 8 Trisomy 21 ( 2nd m.c. chromosomal anomaly in AML) Trisomy 22 Del9q Abnormal 11q23 Normal karyotype -X    karyotype -Y karyotype	Age < 2yrs, >60 yrs ECOG performance status >1 h/o hematological disorder prior chemotherapy leukocytosis>1 lakh/mm3 LDH↑ Extramedullary disease CNS disease Delayed cytoreduction Dysplastic megakaryotypes Megaloblastic erythrocytosis FAB type M0,M6,M7 CD34+ myeloid cells MDR-1 efflus expression Monosomy 5 Monosomy 7 Del  7q Del 5q Abnormal 3q Complex cytogenetics Age >60 ↑LDH t( 6;9) 3q21 3q26 inv.3 complex karyotype MK+ive (monocyte karyotype+ive) FLT-3/stem cell kinase-1/fetal liver kinase-2  mutation §  Best studied receptor & its response on prognosis is  FLT-3 §  High peripheral blast count §  High relapse rate