Predictive Value of Acute Phase Proteins on the Prognosis of Patients with Acute Myeloid Leukemia.
10.19746/j.cnki.issn.1009-2137.2022.04.017
- Author:
Xiu-Ji WU
1
;
Yong-Qing WANG
2
;
Xiao-Yang YANG
3
;
Xue-Shu LIN
1
;
Mei-Hua QIU
1
Author Information
1. Department of Laboratory Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, Hainan Province, China.
2. Department of Laboratory Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, Hainan Province, China,E-mail: 58287677@qq.com.
3. Department of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou 570208, Hainan Province, China.
- Publication Type:Journal Article
- Keywords:
C-reactive protein;
acute myeloid leukemia;
ferritin;
fibrinogen;
serum albumin
- MeSH:
Acute-Phase Proteins/therapeutic use*;
C-Reactive Protein;
Disease-Free Survival;
Ferritins/therapeutic use*;
Humans;
Leukemia, Myeloid, Acute/genetics*;
Middle Aged;
Mutation;
Prognosis;
Remission Induction;
Retrospective Studies;
fms-Like Tyrosine Kinase 3
- From:
Journal of Experimental Hematology
2022;30(4):1086-1093
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To analyze the predictive value of acute phase proteins (APPs) on the prognosis of patients with acute myeloid leukemia (AML).
METHODS:293 AML patients who met the study requirements from January 2015 to April 2021 were collected, their clinical characteristics and pre-treatment APPs levels ［including albumin (ALB), fibrinogen (FIB), C-reactive protein (CRP), Ferritin (FER)］ were followed up and investigated. Pearson correlation coefficient was used to analyze the correlation between APPs. Logistic regression was used to analyze the risk factors for mortality in AML patients. ROC curve was used to analyze the predictive value of APP for mortality in AML patients, and Kaplan-Meier survival analysis was used to compare the effect of APPs on complete remission (CR) rate, overall survival (OS), disease-free survival (DFS), and progression-free survival rate (PFS) of AML patients.
RESULTS:Pearson correlation analysis showed that there were negative correlations between ALB and CRP (r=-0.134, P=0002), as well as ALB and FER (r=-0.148, P=0.001). There were correlations between FER and CRP (r=0361, P＜0.001), as well as FER and FIB (r=0.293, P＜0.001). Logistic regression analysis showed that advanced age (>50 years) (OR=1.87, 95% CI=1.25-2.15, P＜0.001), relapse after treatment (OR=2.11, 95% CI=111-3.18, P=0.003), FLT3-ITD mutation (OR=2.59, 95% CI=1.10-4.12, P＜0.001), CRP≥524 mg/L (OR=1.21, 95% CI=1.02-2.14, P=0.024), CFA (CFA=CRP*FIB/ ALB)≥3 (OR=2.41, 95% CI=1.65-6.47, P＜0.001), and FER≥1145.58 mg/ml (OR=1.67, 95% CI=1.15-3.75, P＜0.001) were the risk factors for the survival of AML patients. ROC curve analysis showed that FER (AUC=0.752, 95% CI=0.681-0823, P＜0.001, the best cut-off value=1220.56 mg/ml) and CFA (AUC=0.804, 95% CI=0.741-0.868, P＜0.001, the best cut-off value=3.00) had higher predictive value for the survival of AML patients. The remission rate, PFS, DFS, and OS in the low CFA group (CFA≤3) were significantly higher than those in the high CFA group (CFA＞3), and the overall mortality rate was lower than that in the high CFA group; the remission rate, PFS, DFS, and OS in the low FER group (FER≤1220.56 mg/ml) were significantly higher than those in the high FER group (FER＞1220.56 mg/ml), while the overall mortality rate was lower than that in the high FER group, and the difference is statistically significant.
CONCLUSION:The CFA value and FER level before treatment in AML patients can independently predict the prognosis of patients, and high levels of CFA and FER are associated with poor prognosis of AML patients.
