Institute of Hematology, Ningbo First Hospital, No.59 Liuting Street, Ningbo, 315000, Zhejiang, People's Republic of China.
Cancer Radiotherapy and Chemotherapy Center, Ningbo First Hospital, No.59 Liuting Street, Ningbo, Zhejiang, People's Republic of China.
BMC Cancer. 2022 Jan 31;22(1):127. doi: 10.1186/s12885-022-09248-2.
Myelodysplastic syndromes (MDS) is a group of heterogeneous myeloid clonal diseases originating from hematopoietic stem cells. It has been demonstrated that apolipoproteins A1(ApoA1) are associated with disease risk in many cancer types. However, there still lacks evidence regarding the link between ApoA1 and MDS. This study was designed to investigate the prognostic value of pretreatment ApoA1 levels in MDS patients.
We retrospectively analyzed a cohort of 228 MDS patients to explore the prognostic value of the serum ApoA1 levels at diagnosis. Patients were divided into the high ApoA1 group and the low ApoA1 group. The prognostic significance was determined by univariate and multivariate Cox hazard models.
MDS patients with low ApoA1 levels had significantly shorter overall survival (OS, P < 0.0001) along with a higher frequency of TP53 mutation (P = 0.002). Based on univariate analysis, age (≥ 60 years), gender (male), lower levels of hemoglobin (< 10 g/dl), HDL (≤0.91 mmol/L), higher bone marrow blast percentage (> 5%), higher IPSS-R scores and poorer karyotype were significantly associated with decreased OS. However, low ApoA1 level did not influence leukemia-free survival (LFS, P = 0.367). Multivariate Cox proportional hazards regression analysis indicated that low ApoA1 level (≤ 1.02 g/L) was also an independent adverse prognostic factor for OS in MDS (P = 0.034).
Decreased ApoA1 level predicts a poor prognosis of MDS patients and thus provides a novel evaluation factor for them that is independent of the IPSS-R system.
骨髓增生异常综合征（MDS）是一组起源于造血干细胞的异质性髓系克隆疾病。已有研究表明载脂蛋白 A1（ApoA1）与许多癌症类型的疾病风险相关。然而，关于 ApoA1 与 MDS 之间的联系仍缺乏证据。本研究旨在探讨 MDS 患者治疗前 ApoA1 水平的预后价值。
我们回顾性分析了 228 例 MDS 患者的队列，以探讨诊断时血清 ApoA1 水平的预后价值。患者分为 ApoA1 水平高组和 ApoA1 水平低组。通过单因素和多因素 Cox 风险模型确定预后意义。
ApoA1 水平低的 MDS 患者的总生存期（OS）明显缩短（P<0.0001），且 TP53 突变频率更高（P=0.002）。基于单因素分析，年龄（≥60 岁）、性别（男）、血红蛋白水平较低（<10g/dl）、高密度脂蛋白（HDL）水平较低（≤0.91mmol/L）、骨髓原始细胞比例较高（>5%）、IPSS-R 评分较高和核型较差与 OS 降低显著相关。然而，ApoA1 水平较低并不影响无白血病生存（LFS，P=0.367）。多因素 Cox 比例风险回归分析表明，ApoA1 水平较低（≤1.02g/L）也是 MDS OS 的独立不良预后因素（P=0.034）。
ApoA1 水平降低预示 MDS 患者预后不良，为 MDS 患者提供了一个独立于 IPSS-R 系统的新的评估因素。
