Liu Chen, Zhao Lei, Zhao Jingzhong, Xu Qinzhu, Song Ying, Wang Hui
Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China.
Leuk Res. 2017 Feb;53:57-64. doi: 10.1016/j.leukres.2016.12.004. Epub 2016 Dec 20.
ADAMTS-13 is crucial for maintaining the normal size of vWF. Besides thrombotic thrombocytopenic purpura (TTP), decreased ADAMTS-13 had also been reported in patients with malignancy. However, the knowledge of expression and potential role of ADAMTS-13 in hematological malignancies is still limited. We measured and compared ADAMTS-13 levels in the plasma of 82 acute myeloid leukemia (AML) patients and 34 healthy controls and found that AML patients possessed lower ADAMTS-13 than controls. AML patients with infections possessed lower level of ADAMTS-13 than patients without infections and ADAMTS-13 levels were negatively correlated with C-reactive protein(CRP), IL-6, TNFα and IL-1β. Furthermore, high risk AML patients are with lower ADAMTS-13 than patients with low risk. ADAMTS-13 negatively correlated with ISTH scores and patients accompanying DIC possessed lower ADAMTS-13.Multivariate analyses proved that low level of ADAMTS-13 is an independent risk factor for AML outcome. To conclude, ADAMTS-13 levels are decreased in plasma of AML patients and the level of ADAMTS-13 is related to inflammation and infection of AML patients. Besides, low ADAMTS-13 level is one potential risk factor for AML patients.
ADAMTS-13对于维持血管性血友病因子（vWF）的正常大小至关重要。除血栓性血小板减少性紫癜（TTP）外，恶性肿瘤患者中也有ADAMTS-13水平降低的报道。然而，关于ADAMTS-13在血液系统恶性肿瘤中的表达及潜在作用的了解仍然有限。我们检测并比较了82例急性髓系白血病（AML）患者和34名健康对照者血浆中的ADAMTS-13水平，发现AML患者的ADAMTS-13水平低于对照组。有感染的AML患者的ADAMTS-13水平低于无感染的患者，且ADAMTS-13水平与C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子α（TNFα）和白细胞介素-1β（IL-1β）呈负相关。此外，高危AML患者的ADAMTS-13水平低于低危患者。ADAMTS-13与国际血栓与止血学会（ISTH）评分呈负相关，伴有弥散性血管内凝血（DIC）的患者ADAMTS-13水平较低。多因素分析证明，ADAMTS-13水平低是AML预后的独立危险因素。总之，AML患者血浆中ADAMTS-13水平降低，且ADAMTS-13水平与AML患者的炎症和感染有关。此外，ADAMTS-13水平低是AML患者的一个潜在危险因素。
