Serum albumin is associated with the inherent property of acute myeloid leukemia and correlates with patient outcomes.

IF 1.5 Q3 HEMATOLOGY 血液科学(英文) Pub Date : 2024-05-10 eCollection Date: 2024-04-01 DOI:10.1097/BS9.0000000000000189
Jiayuan Chen, Yan Hui, Yujia Zhai, Miao Yang, Xue Zhang, Yingchang Mi, Jianxiang Wang, Hui Wei
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Abstract

An accurate prognostic model for acute myeloid leukemia (AML) can guide personalized treatment. In our prospective cohort of 591 patients newly diagnosed with AML, we evaluated the prognostic significance of serum albumin levels. We recognized baseline serum albumin as a prognostic factor by univariate Cox regression analysis (albumin-high vs albumin-low: overall survival [OS]: hazard ratio [HR]: 0.679, 95% confidence interval [CI]: 0.529-0.870, P = .002; cumulative incidence of relapse [CIR]: HR: 0.705, 95% CI: 0.530-0.938, P = .017) and multivariate Cox regression analysis (OS: HR per g/L: 0.966, 95% CI: 0.940-0.993, P = .014; CIR: HR per g/L: 0.959, 95% CI: 0.927-0.993, P = .017). In the subgroup analysis, serum albumin was prognostic significant in patients who received intermediate-dose cytarabine combined with daunorubicin and omacetaxine mepesuccinate induction (albumin-high vs albumin-low: OS: HR: 0.585, 95% CI: 0.397-0.863, P = .007; CIR: HR: 0.551, 95% CI: 0.353-0.861, P = .009) rather than those receiving conventional-dose induction regimens. In addition, the impact of baseline serum albumin level was evident in patients with intermediate European LeukemiaNet risk (albumin-high vs albumin-low: OS: HR: 0.617, 95% CI: 0.424-0.896, P = .011; CIR: HR: 0.617, 95% CI: 0.388-0.979, P = .040). Gene set enrichment analysis revealed that leukemia stem cell signatures were enriched in patients with low serum albumin levels. Our study suggested that baseline serum albumin level was associated with the inherent properties of AML and correlated with patient outcomes.

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血清白蛋白与急性髓性白血病的固有特性有关,并与患者的预后相关。
一个准确的急性髓性白血病(AML)预后模型可以指导个性化治疗。我们在新诊断为急性髓细胞白血病的 591 名患者的前瞻性队列中评估了血清白蛋白水平的预后意义。通过单变量 Cox 回归分析,我们发现基线血清白蛋白是一个预后因素(白蛋白高 vs 白蛋白低:总生存率 [OS]:危险比 [HR]:0.679,95% 置信度 [HR]:0.679,95% 置信度 [HR]:0.679):0.679,95%置信区间[CI]:0.529-0.870,P = .002;复发累积发生率 [CIR]:HR:0.705,95% CI:0.530-0.938,P = .017)和多变量 Cox 回归分析(OS:每 g/L HR:0.966,95% CI:0.940-0.993,P = .014;CIR:每 g/L HR:0.959,95% CI:0.927-0.993,P = .017)。在亚组分析中,血清白蛋白对接受中等剂量阿糖胞苷联合多柔比星和甲磺酸奥美他辛诱导治疗的患者具有显著的预后意义(白蛋白高 vs 白蛋白低:OS:0.940-0.993,P = 0.014;CIR:每克/升 HR:0.959,95 CI:0.927-0.993,P = 0.017):OS:HR:0.585,95% CI:0.397-0.863,P = .007;CIR:HR:0.551,95% CI:0.353-0.861,P = .009)。此外,基线血清白蛋白水平对欧洲白血病网络(European LeukemiaNet)中等风险患者(白蛋白高 vs 白蛋白低)的影响也很明显:OS:HR:0.617,95% CI:0.424-0.896,P = .011;CIR:HR:0.617,95% CI:0.388-0.979,P = .040)。基因组富集分析显示,白血病干细胞特征在血清白蛋白水平低的患者中富集。我们的研究表明,基线血清白蛋白水平与急性髓细胞性白血病的固有特性有关,并与患者的预后相关。
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CiteScore
1.70
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审稿时长
10 weeks
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