Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.
Ann Hematol. 2024 Mar;103(3):771-780. doi: 10.1007/s00277-024-05645-8. Epub 2024 Jan 31.
The objective of this study was to analyze the correlation between skeletal muscle mass and the distribution of peripheral blood lymphocytes and natural killer (NK) cells, as well as their impact on prognosis in patients with acute myeloid leukemia (AML). A retrospective analysis was conducted on 211 newly diagnosed AML patients, evaluating skeletal muscle index (SMI), NK cell proportion, and absolute value, along with relevant clinical data. Linear regression and Spearman's correlation coefficient were used to assess the relationship between various indicators and SMI, followed by multiple linear regression for further modeling. Univariate and multivariate Cox proportional hazards regression models were used to identify independent predictors for overall survival (OS). Among the 211 AML patients, 38 cases (18.0%) were diagnosed with sarcopenia. Multiple linear regression analysis included weight, fat mass, ECOG score, body mass index, and peripheral blood NK cell proportion, constructing a correlation model for SMI (R = 0.745). Univariate analysis identified higher NK cell count (> 9.53 × 10/L) as a poor predictor for OS. Multivariate Cox proportional hazards regression model indicated that age ≥ 60 years, PLT < 100 × 10/L, ELN high risk, sarcopenia, and B cell count > 94.6 × 10/L were independent adverse prognostic factors for AML patients. Low skeletal muscle mass may negatively impact the count and function of NK cells, thereby affecting the prognosis of AML. However, further basic and clinical research is needed to explore the specific mechanisms underlying the relationship between NK cells and SMI in AML.
本研究旨在分析骨骼肌质量与周围血淋巴细胞和自然杀伤（NK）细胞分布的相关性，以及它们对急性髓系白血病（AML）患者预后的影响。对 211 例新诊断的 AML 患者进行回顾性分析，评估骨骼肌指数（SMI）、NK 细胞比例和绝对值以及相关临床数据。采用线性回归和 Spearman 相关系数评估各指标与 SMI 的关系，然后进行多元线性回归建模。采用单因素和多因素Cox 比例风险回归模型确定总生存期（OS）的独立预测因素。在 211 例 AML 患者中，38 例（18.0%）诊断为肌少症。多元线性回归分析包括体重、脂肪量、ECOG 评分、体重指数和外周血 NK 细胞比例，构建了 SMI 的相关模型（R=0.745）。单因素分析发现较高的 NK 细胞计数（>9.53×10/L）是 OS 的不良预测因素。多因素 Cox 比例风险回归模型表明，年龄≥60 岁、血小板<100×10/L、ELN 高危、肌少症和 B 细胞计数>94.6×10/L 是 AML 患者独立的不良预后因素。骨骼肌质量低可能会对 NK 细胞的数量和功能产生负面影响，从而影响 AML 的预后。然而，需要进一步的基础和临床研究来探讨 AML 中 NK 细胞与 SMI 之间关系的具体机制。
