Wake Forest School of Medicine, Winston-Salem, NC, USA.
Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC, USA.
Cancer Med. 2020 Apr;9(7):2403-2413. doi: 10.1002/cam4.2835. Epub 2020 Feb 12.
Standardized phase angle (SPhA) is a tool used to estimate body composition and cell membrane integrity. Standardized phase angle has been shown to predict survival in solid malignancies and hematopoietic stem cell transplant patients. We investigated the predictive value of SPhA on 60-day mortality, overall survival (OS), and length of hospital stay (LHS) for adults with acute myelogenous and lymphoblastic leukemia (AML and ALL). Consecutive patients ≥18 years with newly diagnosed acute leukemia receiving intensive chemotherapy were enrolled. Phase angle measurements were taken on day 1 of therapy for all patients and on the day of nadir marrow for AML patients. Measurements were standardized by BMI, gender, and age to calculate the SPhA. The difference between SPhA at nadir bone marrow compared to day 1 of induction was used to calculate change in SPhA. A cutoff of 25th percentile was used to dichotomize baseline SPhA. Among 100 patients, 88% were AML, 56% were female, and mean age was 59 years. Though not statistically significant, OS by Kaplan-Meier analysis was shorter for those below the 25th percentile SPhA compared to those above (median OS: 11.0 months vs 19.5 months; P = .09). Lower baseline SPhA was associated with increased incidence of 60-day mortality in univariable (odds ratio [OR] = 5.25; 1.35, 20.44; P = .02) but not multivariable analysis (OR = 3.12; 0.67, 14.48; P = .15) adjusted for age, creatinine, and cytogenetics. Increased change in SPhA was associated with worse OS (hazard ratio = 1.15; 1.00,1.33; P = .05) in multivariable analysis. Standardized phase angle is a rapid, noninvasive, and objective measure that may be used to inform risk stratification.
标准化相位角（SPhA）是一种用于估计身体成分和细胞膜完整性的工具。已证明标准化相位角可预测实体恶性肿瘤和造血干细胞移植患者的生存率。我们研究了 SPhA 对急性髓细胞性和淋巴母细胞性白血病（AML 和 ALL）成人 60 天死亡率、总生存率（OS）和住院时间（LHS）的预测价值。纳入了接受强化化疗的新诊断为急性白血病的连续≥18 岁的患者。所有患者在治疗的第 1 天和 AML 患者的骨髓最低点进行相位角测量。通过 BMI、性别和年龄对测量值进行标准化，以计算 SPhA。通过计算 SPhA 在骨髓最低点与诱导第 1 天之间的变化来计算 SPhA 的变化。使用第 25 百分位作为截断值将基线 SPhA 分为二项式。在 100 名患者中，88%为 AML，56%为女性，平均年龄为 59 岁。尽管 Kaplan-Meier 分析的 OS 无统计学意义，但低于第 25 百分位 SPhA 的患者的 OS 更短（中位 OS：11.0 个月 vs 19.5 个月；P=0.09）。单变量分析中，较低的基线 SPhA 与 60 天死亡率的发生率增加相关（优势比[OR] = 5.25；1.35，20.44；P=0.02），但多变量分析（OR = 3.12；0.67，14.48；P=0.15）在调整年龄、肌酐和细胞遗传学后则无相关性。SPhA 变化增加与 OS 较差相关（危险比=1.15；1.00，1.33；P=0.05），在多变量分析中。标准化相位角是一种快速、无创和客观的测量方法，可用于风险分层。
