Wang Zhenzhen, Yuan Jing, Zhou Nan, Zhang Jianfeng
Department of Hematology, the Second Hospital of Hebei Medical University, Hebei, Shijiazhuang, China.
The Second Department of General Surgery, the Fourth Hospital of Hebei Medical University, Hebei, Shijiazhuang, China.
Front Oncol. 2025 Jan 13;14:1521179. doi: 10.3389/fonc.2024.1521179. eCollection 2024.
Stromal-cell-derived factor 1 (SDF-1) plays a crucial role in hematopoiesis and has been implicated in acute myeloid leukemia (AML) pathogenesis. Understanding its relationship with chemotherapy outcomes could lead to improved therapeutic approaches for elderly AML patients.
This study retrospectively analyzed the medical records of elderly AML patients (n = 187) and compared serum SDF-1α levels with age-matched controls (n = 120). Patients received CAG (cytarabine, aclarubicin, and G-CSF)-based chemotherapy, and serum SDF-1α levels were assessed using ELISA.
Serum SDF-1α levels were significantly elevated in elderly AML patients compared to controls (p < 0.001). Receiver operating characteristic (ROC) analysis confirmed its diagnostic relevance, revealing the area under the ROC curve (AUC) of 0.76. Factors such as age, French-American-British (FAB) classification, Eastern Cooperative Oncology Group (ECOG) performance status, primary AML status, white blood cell count, and bone marrow blast cell ratio, were confirmed to be prognostically relevant. Serum SDF-1α levels were elevated in patients who did not achieve complete remission (NCR) compared to those in complete remission (CR). ROC analysis further highlighted the predictive capability of serum SDF-1α for chemotherapy responsiveness. Independent predictors of treatment failure included age, FAB classification, ECOG status, and serum SDF-1α levels. Following chemotherapy, serum SDF-1α levels decreased in patients in CR but remained unchanged in those in NCR. Higher baseline levels of SDF-1α were associated with shorter overall survival.
Elevated serum SDF-1α levels in elderly AML patients are associated with poor chemotherapy response and shorter survival. Baseline serum SDF-1α levels could serve as a prognostic marker for CAG-based treatment outcomes.
基质细胞衍生因子1（SDF-1）在造血过程中起关键作用，并且与急性髓系白血病（AML）的发病机制有关。了解其与化疗结果的关系可能会为老年AML患者带来更好的治疗方法。
本研究回顾性分析了老年AML患者（n = 187）的病历，并将血清SDF-1α水平与年龄匹配的对照组（n = 120）进行比较。患者接受基于CAG（阿糖胞苷、阿克拉霉素和G-CSF）的化疗，并使用酶联免疫吸附测定法评估血清SDF-1α水平。
与对照组相比，老年AML患者的血清SDF-1α水平显著升高（p < 0.001）。受试者工作特征（ROC）分析证实了其诊断相关性，显示ROC曲线下面积（AUC）为0.76。年龄、法国-美国-英国（FAB）分类、东部肿瘤协作组（ECOG）体能状态、原发性AML状态、白细胞计数和骨髓原始细胞比例等因素被证实与预后相关。与完全缓解（CR）的患者相比，未达到完全缓解（NCR）的患者血清SDF-1α水平升高。ROC分析进一步突出了血清SDF-1α对化疗反应性的预测能力。治疗失败的独立预测因素包括年龄、FAB分类、ECOG状态和血清SDF-1α水平。化疗后，CR患者的血清SDF-1α水平下降，而NCR患者的血清SDF-1α水平保持不变。SDF-1α的基线水平较高与总生存期较短相关。
老年AML患者血清SDF-1α水平升高与化疗反应不佳和生存期较短有关。基线血清SDF-1α水平可作为基于CAG治疗结果的预后标志物。
