C 反应蛋白和白蛋白对急性髓性白血病患者预后的影响。

EJHaem Pub Date : 2024-10-17 DOI:10.1002/jha2.1022
Espen Talseth Skar, Øystein Wendelbo, Håkon Reikvam
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摘要

背景:急性髓性白血病(AML)是一种侵袭性、异质性的恶性疾病。患者年龄、合并症和疾病特异性遗传异常被认为是治疗反应的主要决定因素。近年来已经阐明了营养状况和炎症在各种恶性肿瘤(包括AML)中影响治疗结果的重要性。目的:评估c反应蛋白-白蛋白比率(CAR)和格拉斯哥预后评分(GPS)在预测AML患者总生存(OS)率方面的预后价值。材料与方法:纳入189例接受标准阿糖胞苷和蒽环类药物诱导治疗的AML患者。收集基线人口统计学、临床和实验室数据,并登记所有患者的治疗结果和生存期。结果:即使在亚组分析中,也没有发现AML患者的CAR与预后之间的显著关联。低白蛋白血症是所有患者生存不良的独立预测因子(生存期28 vs. 16个月;p = 0.015)。结果在≥60岁的患者中保持一致(中位生存期15 vs 6个月;p = 0.020)。结论:急性髓性白血病患者炎症加剧和营养状况不佳与不良预后相关。这些见解具有指导临床决策的潜力,为符合条件的AML患者的诱导治疗提供易于获取的预后信息。
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The prognostic impact of C-reactive protein and albumin in patients diagnosed with acute myeloid leukaemia

Background

Acute myeloid leukaemia (AML) is an aggressive and heterogeneous malignant disease. Patient age, comorbidities and disease-specific genetic abnormalities are recognized as primary determinants of treatment response. Recent years have elucidated the significance of nutritional status and inflammation across various malignancies, including AML, in influencing treatment outcomes.

Aims

To assess the prognostic value of the C-reactive protein-albumin ratio (CAR) and the Glasgow Prognostic Score (GPS) in predicting overall survival (OS) rates among patients diagnosed with AML.

Material and methods

189 AML patients receiving standard cytarabine and anthracycline-based induction treatment were included. Baseline demographic, clinical and laboratory data were collected, and treatment outcomes and survival were registered for all patients.

Results

No significant association between CAR and prognosis among AML patients was found, even in subgroup analyses. Hypoalbuminemia was an independent predictor of poor survival among all patients (OS 28 vs. 16 months; p < 0.02). Patients with a GPS of 0 or 1 demonstrated superior OS compared to those with a GPS of 2 (median OS 28 vs. 16 months, respectively; p = 0.015). Results remained consistent among patients ≥ 60 years (median OS 15 vs. 6 months; p = 0.020).

Conclusion

Heightened inflammation and suboptimal nutritional status correlate with unfavourable prognoses in AML patients. Such insights hold the potential for guiding clinical decision-making, offering easily accessible prognostic information for the induction treatment of eligible AML patients.

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