Relations between Peripheral Blood Blast Clearance Time and Albumin Level at Initial Diagnosis during Induction Chemotherapy and Genetic Mutations and Prognosis in Patients with Acute Myeloid Leukemia

Ruiting ZHANG; Bin YAN; Zuyan LI; Jinmin SUN; Jin YAO

doi:10.12259/j.issn.2095-610X.S20240817

Volume 45 Issue 8

Aug. 2024

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2024 > 45(8): 117-124

Ruiting ZHANG, Bin YAN, Zuyan LI, Jinmin SUN, Jin YAO. Relations between Peripheral Blood Blast Clearance Time and Albumin Level at Initial Diagnosis during Induction Chemotherapy and Genetic Mutations and Prognosis in Patients with Acute Myeloid Leukemia[J]. Journal of Kunming Medical University, 2024, 45(8): 117-124. doi: 10.12259/j.issn.2095-610X.S20240817

Citation:

Ruiting ZHANG, Bin YAN, Zuyan LI, Jinmin SUN, Jin YAO. Relations between Peripheral Blood Blast Clearance Time and Albumin Level at Initial Diagnosis during Induction Chemotherapy and Genetic Mutations and Prognosis in Patients with Acute Myeloid Leukemia[J]. Journal of Kunming Medical University, 2024, 45(8): 117-124. doi: 10.12259/j.issn.2095-610X.S20240817

Citation:

Ruiting ZHANG, Bin YAN, Zuyan LI, Jinmin SUN, Jin YAO. Relations between Peripheral Blood Blast Clearance Time and Albumin Level at Initial Diagnosis during Induction Chemotherapy and Genetic Mutations and Prognosis in Patients with Acute Myeloid Leukemia[J]. Journal of Kunming Medical University, 2024, 45(8): 117-124. doi: 10.12259/j.issn.2095-610X.S20240817

PDF( 1111 KB)

Relations between Peripheral Blood Blast Clearance Time and Albumin Level at Initial Diagnosis during Induction Chemotherapy and Genetic Mutations and Prognosis in Patients with Acute Myeloid Leukemia

doi: 10.12259/j.issn.2095-610X.S20240817

Dept. of Oncology，The 2nd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650033，China

Received Date: 2024-04-08
Available Online: 2024-07-06
Publish Date: 2024-08-25

Abstract

Abstract

Objective To investigate the relationship between peripheral blood blast clearance （PBBC） time during induction chemotherapy and albumin （ALB） level at diagnosis and genetic mutation and prognosis in acute myeloid leukemia patients （AML）. Methods Clinical data of 175 AML patients initially diagnosed from January 2017 to May 2023 at the Second Affiliated Hospital of Kunming Medical University were collected for a retrospective analysis. ROC curve was used to determine the optimal cut-off value of PBBC as 6.5 days. PBBC ≤ 6.5 days were classified as the Peripheral Blood Primitive Blood Cell Short-Term Clearance Group （EBC）, and PBBC > 6.5 days were classified as the Peripheral Blood Primitive Blood Cell Long-Term Clearance Group （DBC）. A simple prognostic model was established based on PBBC and ALB at initial diagnosis, dividing patients into groups a, b, and c: group A （PBBC ≤ 6.5 d, ALB > 34.45 g/L, no risk factors）, group b （PBBC > 6.5 d, ALB > 34.45 g/L or PBBC ≤ 6.5 d, ALB ≤ 34.45 g/L, 1 risk factor）, group c （PBBC > 6.5 d, ALB ≤ 34.45 g/L, 2 risk factors）. Genetic mutations and OS were compared among the three groups of patients; differences in various parameters were evaluated using t-test and chi-squared test or rank sum test, and survival analysis was performed using the Kaplan-Meier method. Results COX regression analysis showed that PBBC and ALB were independent factors affecting prognosis, with statistical significance （P < 0.05）. Comparison of OS among groups revealed median OS values of not reached, 1.86 a, and 0.93 a, respectively （a vs. b group, P < 0.001; a vs. c group, P < 0.001; b vs. c group, P = 0.001）, with statistically significant differences indicating that the OS and PFS of the no-risk group were better than those with 1 to 2 risk factors.It was found that CEBPA double mutation and NPM1 gene mutation among the three groups were not statistically significant （P > 0.05）, but C-KIT gene mutation was statistically significant （P < 0.05）. Conclusion PBBC and ALB are independent risk factors for the prognosis of AML patients. A simple prognostic model composed of PBBC and ALB can provide a basis for the selection of precise and personalized induction chemotherapy regimens, and provide reference for determining gene mutations and prognosis in newly diagnosed AML patients.
- Acute myeloid leukemia,
- Peripheral blood blast clearance,
- Albumin,
- Gene mutation,
- Prognosis

FullText(HTML)

References(20)

References

[1]	Thoms J,Beck D,Pimanda J E. Transcriptional networks in acute myeloid leukemia[J]. Genes Chromosomes Cancer,2019,58(12):859-874. doi: 10.1002/gcc.22794
[2]	Arellano M,Pakkala S,Langston A,et al. Early clearance of peripheral blood blasts predicts response to induction chemotherapy in acute myeloid leukemia[J]. Cancer,2012,118(21):5278-5282. doi: 10.1002/cncr.27494
[3]	Soeters P B,Wolfe R R,Shenkin A. Hypoalbuminemia: Pathogenesis and clinical significance[J]. Journal of Parenteral and Enteral Nutrition,2019,43(2):181-193. doi: 10.1002/jpen.1451
[4]	Hohloch K,Ziepert M,Truemper L,et al. Low serum albumin is an independent risk factor in elderly patients with aggressive B-cell lymphoma: Results from prospective trials of the German high-grade non-Hodgkin's lymphoma study group[J]. eJHaem,2020,1(1):181-187. doi: 10.1002/jha2.61
[5]	Zhang L,Fang Y,Li L,et al. Human serum albumin-based drug-free macromolecular therapeutics: Apoptosis induction by coiled-coil-mediated cross-linking of CD20 antigens on lymphoma B cell surface[J]. Macromol Biosci,2018,18(11):e1800224. doi: 10.1002/mabi.201800224
[6]	中华医学会血液学分会白血病淋巴瘤学组. 成人急性髓系白血病(非急性早幼粒细胞白血病)中国诊疗指南(2023年版). 中华血液学杂志,2023,44(9): 705-712.
[7]	Pelcovits A,Niroula R. Acute myeloid leukemia: A review[J]. R I Med J (2013),2020,103(3): 38-40.
[8]	Infante M S,Piris M Á,Hernández-Rivas J Á. Molecular alterations in acute myeloid leukemia and their clinical and therapeutical implications[J]. Med Clin (Barc),2018,151(9):362-367. doi: 10.1016/j.medcli.2018.05.002
[9]	Konopleva M,Letai A. BCL-2 inhibition in AML: An unexpected bonus?[J]. Blood,2018,132(10):1007-1012. doi: 10.1182/blood-2018-03-828269
[10]	Pei S,Pollyea D A,Gustafson A,et al. Monocytic subclones confer resistance to venetoclax-based therapy in patients with acute myeloid leukemia[J]. Cancer Discov,2020,10(4):536-551. doi: 10.1158/2159-8290.CD-19-0710
[11]	Holtzman N G,El Chaer F,Baer M R,et al. Peripheral blood blast rate of clearance is an independent predictor of clinical response and outcomes in acute myeloid leukaemia[J]. British Journal of Haematology,2020,188(6):881-887. doi: 10.1111/bjh.16261
[12]	Holowiecki J,Grosicki S,Giebel S,et al. Cladribine,but not fludarabine,added to daunorubicin and cytarabine during induction prolongs survival of patients with acute myeloid leukemia: A multicenter,randomized phase III study[J]. J Clin Oncol,2012,30(20):2441-2448. doi: 10.1200/JCO.2011.37.1286
[13]	Wang H,Mao L,Yang M,et al. Venetoclax plus 3 + 7 daunorubicin and cytarabine chemotherapy as first-line treatment for adults with acute myeloid leukaemia: A multicentre,single-arm,phase 2 trial[J]. The Lancet Haematology,2022,9(6):415-424. doi: 10.1016/S2352-3026(22)00106-5
[14]	Sevindik O G,Guc Z,Kahraman S,et al. Hypoalbuminemia is a surrogate biomarker of poor prognosis in myelodysplastic syndrome even when adjusting for comorbidities[J]. Leuk Lymphoma,2015,56(9):2552-2555. doi: 10.3109/10428194.2015.1014362
[15]	Yokus O,Sunger E,Cinli TA,et al. Serum albumin and ferritin levels: A practical indicator of prognosis in acute myeloid leukemia over 50 years of age?[J]. American Journal of Blood Research,2022,12(3):97-104.
[16]	Heath E M,Chan S M,Minden M D,et al. Biological and clinical consequences of NPM1 mutations in AML[J]. Leukemia,2017,31(4):798-807. doi: 10.1038/leu.2017.30
[17]	Ayatollahi H,Shajiei A,Sadeghian M H,et al. Prognostic importance of C-KIT mutations in core binding factor acute myeloid leukemia: A systematic review[J]. Hematol Oncol Stem Cell Ther,2017,10(1):1-7. doi: 10.1016/j.hemonc.2016.08.005
[18]	Abdellateif M S,Bayoumi A K,Mohammed M A. C-Kit receptors as a therapeutic target in cancer: Current Insights[J]. Onco Targets Ther,2023,16:785-799.
[19]	Deng D X,Zhu H H,Liu Y R,et al. Minimal residual disease detected by multiparameter flow cytometry is complementary to genetics for risk stratification treatment in acute myeloid leukemia with biallelic CEBPA mutations[J]. Leuk Lymphoma,2019,60(9):2181-2189. doi: 10.1080/10428194.2019.1576868
[20]	Yuan J,He R,Alkhateeb H B. Sporadic and familial acute myeloid leukemia with CEBPA mutations[J]. Curr Hematol Malig Rep,2023,18(5):121-129. doi: 10.1007/s11899-023-00699-3

Relative Articles(20)

Relative Articles

[1]	Bowen TAN, Yun LIANG, Huan CHEN, Yi LEI, Yuhan WANG, Yan TIAN. The Prognostic Value of Preoperative Peripheral Blood Inflammatory Markers Combined with Tumor Markers in Resectable Colon Cancer Patients. Journal of Kunming Medical University, 2024, 45(12): 1-5.
[2]	Lizhu ZHAO, Ying DONG, Yue DENG, Lihua YANG. Correlation between Epithelial Cell Related Genes and Prognosis of Patients with Ovarian Cancer based on Single Cell Sequencing. Journal of Kunming Medical University, 2024, 45(4): 9-16. doi: 10.12259/j.issn.2095-610X.S20240402
[3]	Xinyi MEN, Jing ZHAO, Yongchun SHEN, Hui JI, Xiuxia WANG. The Relationship between Peripheral Blood Immunoglobulin，Erythrocyte Sedimentation Rate，Homocysteine and the Degree of Central Nervous System Vasculitis in Children and Their Influence on Prognosis. Journal of Kunming Medical University, 2024, 45(12): 1-7.
[4]	Chunyan LIU, Bingqing CHANG, Chao LI, Xin REN, Xiaoqin LIU. The Relationship between T Lymphocyte Subsets and Pathological Characteristics of Acute Myeloid Leukemia and the Value of Predicting Chemotherapy Prognosis. Journal of Kunming Medical University, 2024, 45(5): 116-122. doi: 10.12259/j.issn.2095-610X.S20240518
[5]	Jiefu TANG, Dexing YANG, Shengzhe LIU, Qiang WANG, Kai FU, Zhenfang WANG, Ying LUAN, Min LI, Rong LIU. A Study on Prognostic Value of Cellular Immunological Indicators in Omicron Variant Infected Elderly Severe Patients. Journal of Kunming Medical University, 2023, 44(12): 87-94. doi: 10.12259/j.issn.2095-610X.S20231214
[6]	Xi ZHENG, Jinzhu MA, Qinchun LI, Yu GAO, Ying PAN, Guibo SONG. Mutation Analysis of OprD Gene in Pseudomonas Aeruginosa with Car-R/ Ceph-S. Journal of Kunming Medical University, 2023, 44(1): 7-11. doi: 10.12259/j.issn.2095-610X.S20230121
[7]	Ran ZHANG, Jie YANG, Enzi FENG, Xiaofeng YUAN, Qing WANG. Correlation between Gene Mutation and Invasiveness in Papillary Thyroid Carcinoma. Journal of Kunming Medical University, 2023, 44(2): 125-132. doi: 10.12259/j.issn.2095-610X.S20230223
[8]	Xiaohua LU, Hongxin YUAN. The Analysis of the Correlation between BTLA，CTLA-4 Gene Polymorphisms and the Efficacy and Prognosis of TACE Combined Targeted Therapy for Liver Cancer. Journal of Kunming Medical University, 2023, 44(9): 126-135. doi: 10.12259/j.issn.2095-610X.S20230927
[9]	Honglan CHEN, Yi WU, Tao HU, Yuming WANG. Potential Value of G6PD Activity Detection in the Peripheral Blood for the Diagnosis and Prognosis of Cervical Cancer Patients with High Risk Human Papillomavirus Infection. Journal of Kunming Medical University, 2022, 43(2): 89-95. doi: 10.12259/j.issn.2095-610X.S20220203
[10]	Yike ZHU, Junsu YANG, Fang QIAN, Haohao WU, Baogang HUANG. Correlation between NLR Value and Prognosis in Patients with Acute Ischemic Stroke before and after Revascularization. Journal of Kunming Medical University, 2022, 43(8): 100-105. doi: 10.12259/j.issn.2095-610X.S20220815
[11]	Ruijuan MA, Feng ZHANG, Ruiting ZHANG, Jin YAO. Effect of Hematopoietic Function Recovery and MRD Status after Induction Chemotherapy on the Prognosis of Patients with Newly Diagnosed Acute Myeloid Leukemia. Journal of Kunming Medical University, 2022, 43(5): 88-94. doi: 10.12259/j.issn.2095-610X.S20220512
[12]	Li-jia ZHU, Xiao-dan MA, Jiang DUAN, Meng LI, Yong-kun HUANG. Difference Analysis of First Liver Function Indexes of Newborns with Different Gestational Age and Birth Weight. Journal of Kunming Medical University, 2021, 42(3): 121-126. doi: 10.12259/j.issn.2095-610X.S20210330
[13]	Jian-pei SU, Wei-meng TIAN, Jun GU, Mi-yu HE. Association between C-reactive Protein/Albumin Ratio and Long-term Prognosis in Elderly Patients with Heart Failure. Journal of Kunming Medical University, 2020, 41(12): 128-132. doi: 10.12259/j.issn.2095-610X.S20201236
[14]	Wu Wen Juan . Combination of Heart-type Fatty Acid-binding Protein and Simple Pulmonary Embolism Severity Index for the Assessment of the Short-term Prognosis in Patients with Acute Pulmonary Embolism. Journal of Kunming Medical University,
[15]	Zhong Fang Fang . . Journal of Kunming Medical University,
[16]	Peng Hui . . Journal of Kunming Medical University,
[17]	Yang Hong . . Journal of Kunming Medical University,
[18]	Xu Jian Xin . . Journal of Kunming Medical University,
[19]	Li Xue Tao . . Journal of Kunming Medical University, 2013, 34(04): 1-1.
[20]	Tan Xiang Lai . . Journal of Kunming Medical University,