急性髓系白血病患者在确诊、复发、菌血症和死亡前后的血浆白蛋白和 C 反应蛋白水平的纵向轨迹模式。
Longitudinal trajectory patterns of plasma albumin and C-reactive protein levels around diagnosis, relapse, bacteraemia, and death of acute myeloid leukaemia patients.
机构信息
Center for Clinical Epidemiology, Odense University Hospital, and Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Kløvervænget 30, Entrance 216, ground floor, 5000, Odense C, Denmark.
OPEN - Odense Patient Data Exploratory Network, Odense University Hospital, J.B. Winsløws Vej 9 A, 5000, Odense C, Denmark.
出版信息
BMC Cancer. 2020 Mar 24;20(1):249. doi: 10.1186/s12885-020-06754-z.
BACKGROUND
No study has evaluated C-reactive protein (CRP) and plasma albumin (PA) levels longitudinally in patients with acute myeloid leukaemia (AML).
METHODS
We studied defined events in 818 adult patients with AML in relation to 60,209 CRP and PA measures. We investigated correlations between CRP and PA levels and daily CRP and PA levels in relation to AML diagnosis, AML relapse, or bacteraemia (all ±30 days), and death (─30-0 days).
RESULTS
On the AML diagnosis date (D0), CRP levels increased with higher WHO performance score (PS), e.g. patients with PS 3/4 had 68.1 mg/L higher CRP compared to patients with PS 0, adjusted for relevant covariates. On D0, the PA level declined with increasing PS, e.g. PS 3/4 had 7.54 g/L lower adjusted PA compared to PS 0. CRP and PA levels were inversely correlated for the PA interval 25-55 g/L (R = - 0.51, p < 10-5), but not for ≤24 g/L (R = 0.01, p = 0.57). CRP increases and PA decreases were seen prior to bacteraemia and death, whereas no changes occurred up to AML diagnosis or relapse. CRP increases and PA decreases were also found frequently in individuals, unrelated to a pre-specified event.
CONCLUSIONS
PA decrease is an important biomarker for imminent bacteraemia in adult patients with AML.
背景
尚无研究对急性髓系白血病（AML）患者的 C 反应蛋白（CRP）和血浆白蛋白（PA）水平进行纵向评估。
方法
我们研究了 818 例成年 AML 患者中与 60209 次 CRP 和 PA 测量相关的明确事件。我们调查了 CRP 和 PA 水平之间的相关性，以及 CRP 和 PA 水平与 AML 诊断、AML 复发或菌血症（均±30 天）和死亡（─30-0 天）的关系。
结果
在 AML 诊断日（D0），CRP 水平随 WHO 表现评分（PS）的升高而升高，例如 PS 3/4 的患者 CRP 水平比 PS 0 的患者高 68.1mg/L，校正了相关协变量。在 D0，PA 水平随 PS 的增加而降低，例如 PS 3/4 的患者校正后的 PA 水平比 PS 0 的患者低 7.54g/L。CRP 和 PA 水平在 PA 间隔 25-55g/L 时呈负相关（R=-0.51，p<10-5），但在≤24g/L 时无相关性（R=0.01，p=0.57）。在发生菌血症和死亡之前，CRP 升高和 PA 降低先于这些事件发生，而在 AML 诊断或复发之前，未发生这些变化。在未发生特定事件的个体中也发现 CRP 升高和 PA 降低的情况很常见。
结论
PA 降低是 AML 成年患者即将发生菌血症的重要生物标志物。
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