[Table 2] No correlation was observed between pretherapeutic nucleosomal DNA levels and bone marrow blast number (r = 0.08; p = 0.722).
However, pretherapeutic nucleosomal DNA levels correlated inversely with bone marrow blast number after 16 days (r = -0.55; p = 0.012) and with the relative reduction of blast number from day 1 to 16 (r = 0.58; p = 0.007).
This hypothesis is further strengthened by our observation that the pretherapeutic levels and the AUC 2 4 of nucleosomal DNA, reflecting the immediate effect of therapy, were related to the percentual reduction of bone marrow blast number from days 1 to 16.
Baseline characteristics for the individual IPSS-R groups (low, intermediate, high), including IPSS score, transfusion burden, bone marrow blast count, number of cytopenias, platelet count, absolute neutrophil count, hemoglobin and cytogenetic complexity, were generally less favorable for patients in the higher IPSS-R risk groups.
Bone marrow cytology showed normal blast numbers, erythropoiesis and megakaryopoiesis, both with discrete dysplastic features, and granulopoiesis.
The International Prognostic Scoring System (IPSS) identified three critical factors that influence survival and AML evolution: risk-based cytogenetic subgroups (good, intermediate and poor karyotypes), bone marrow blast percentage and the number of cytopenias.
The International Prognostic Scoring System (IPSS) is a widely used risk assessment tool [ 6] that stratifies patients into four risk groups based on cytogenetics, the percentage of bone marrow blasts, and the number of cytopenias [ 14].
Corticosteroid drug response was measured by reduction in bone marrow blast counts and absolute peripheral blast counts after 3 days.
Glucocorticoid receptor (GCR) number and the effective concentration of dexamethasone resulting in a 50% reduction of leukemic cell viability in vitro (EC-50) were evaluated at days 0 and 3.Increasing dexamethasone doses resulted in greater marrow blast response (P =.007), with a similar trend in peripheral-blood blast response.
The recently developed Revised International Prognostic Scoring System provides improved prognostication using more refined cytogenetic, marrow blast, and cytopenia parameters.
