Skar Espen Talseth, Wendelbo Øystein, Reikvam Håkon
Department of Clinical Science, University of Bergen K.G. Jebsen Center for Myeloid Blood Cancer Bergen Norway.
Department of Medicine Haukeland University Hospital Bergen Norway.
EJHaem. 2024 Oct 17;5(6):1223-1235. doi: 10.1002/jha2.1022. eCollection 2024 Dec.
Acute myeloid leukaemia (AML) is an aggressive and heterogeneous malignant disease. Patient age, comorbidities and disease-specific genetic abnormalities are recognized as primary determinants of treatment response. Recent years have elucidated the significance of nutritional status and inflammation across various malignancies, including AML, in influencing treatment outcomes.
To assess the prognostic value of the C-reactive protein-albumin ratio (CAR) and the Glasgow Prognostic Score (GPS) in predicting overall survival (OS) rates among patients diagnosed with AML.
189 AML patients receiving standard cytarabine and anthracycline-based induction treatment were included. Baseline demographic, clinical and laboratory data were collected, and treatment outcomes and survival were registered for all patients.
No significant association between CAR and prognosis among AML patients was found, even in subgroup analyses. Hypoalbuminemia was an independent predictor of poor survival among all patients (OS 28 vs. 16 months; < 0.02). Patients with a GPS of 0 or 1 demonstrated superior OS compared to those with a GPS of 2 (median OS 28 vs. 16 months, respectively; = 0.015). Results remained consistent among patients ≥ 60 years (median OS 15 vs. 6 months; = 0.020).
Heightened inflammation and suboptimal nutritional status correlate with unfavourable prognoses in AML patients. Such insights hold the potential for guiding clinical decision-making, offering easily accessible prognostic information for the induction treatment of eligible AML patients.
急性髓系白血病（AML）是一种侵袭性且异质性的恶性疾病。患者年龄、合并症和疾病特异性基因异常被认为是治疗反应的主要决定因素。近年来已经阐明营养状况和炎症在包括AML在内的各种恶性肿瘤中对治疗结果的影响。
评估C反应蛋白-白蛋白比值（CAR）和格拉斯哥预后评分（GPS）在预测AML诊断患者总生存率（OS）方面的预后价值。
纳入189例接受标准阿糖胞苷和蒽环类药物诱导治疗的AML患者。收集基线人口统计学、临床和实验室数据，并记录所有患者的治疗结果和生存情况。
即使在亚组分析中，也未发现AML患者中CAR与预后之间存在显著关联。低白蛋白血症是所有患者生存不良的独立预测因素（OS分别为28个月和16个月；<0.02）。GPS为0或1的患者与GPS为2的患者相比，OS更高（中位OS分别为28个月和16个月；=0.015）。在≥60岁的患者中结果仍然一致（中位OS分别为15个月和6个月；=0.020）。
炎症加剧和营养状况欠佳与AML患者的不良预后相关。这些见解有可能指导临床决策，为符合条件的AML患者的诱导治疗提供易于获取的预后信息。
