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

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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

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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

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References(20)

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