Izumi Akihiko, Tachibana Takayoshi, Nukui Jun, Miyazaki Takuya, Hirose Natsuki, Ohashi Takuma, Tanaka Marika, Katsuki Kengo, Suzuki Taisei, Nakajima Yuki, Matsumoto Kenji, Fujisawa Shin, Tanaka Masatsugu, Nakajima Hideaki
Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Ann Hematol. 2025 Jul 3. doi: 10.1007/s00277-025-06470-3.
Previous studies have shown that C-reactive protein/platelet ratio (CPR) before allogeneic hematopoietic stem cell transplantation (HSCT) is a predictor of survival in patients with hematological malignancies. This multicenter retrospective study aimed to evaluate the clinical significance of CPR from diagnosis to HSCT in patients with acute myeloid leukemia (AML) who underwent HSCT. This cohort included patients with AML who underwent their first HSCT between 2016 and 2021. CPR was evaluated at three time points: at diagnosis, after initial therapy, and pre-HSCT. The cut-off value for CPR was set at 0.05 based on previous studies. In total, 196 patients with a median age of 50 years (range: 15-72). High CPR was associated with the myeloblast ratio in the bone marrow at three points and was associated with high transfusion volume and poor performance status at HSCT. Overall survival (OS) at 2 years according to CPR at diagnosis, after initial therapy, and pre-HSCT (low vs. high) was 67.9% vs. 65.6% (P = 0.477), 72.6% vs. 54.8% (P = 0.022), and 73.1% vs. 49.7% (P < 0.001), and non-relapse mortality (NRM) was 15.8% vs. 19.0% (P = 0.557), 13.8% vs. 21.5% (P = 0.201), and 13.0% vs. 27.6% (P = 0.006), respectively. No significant differences were observed in the relapse rates. In multivariate analysis, the high CPR group pre-HSCT was associated with poor OS (HR = 1.86, 95%CI:1.13-3.07, P = 0.015) and higher NRM (HR = 2.52, 95%CI:1.26-5.04, P = 0.009). Pre-HSCT CPR was associated with post-HSCT OS and NRM. CPR is considered a marker that reflects the disease status and patient condition, suggesting the significance of CPR monitoring.
既往研究表明，异基因造血干细胞移植（HSCT）前的C反应蛋白/血小板比值（CPR）是血液系统恶性肿瘤患者生存的预测指标。这项多中心回顾性研究旨在评估接受HSCT的急性髓系白血病（AML）患者从诊断到HSCT期间CPR的临床意义。该队列包括2016年至2021年间接受首次HSCT的AML患者。在三个时间点评估CPR：诊断时、初始治疗后和HSCT前。根据既往研究，CPR的临界值设定为0.05。共有196例患者，中位年龄为50岁（范围：15 - 72岁）。高CPR与三个时间点骨髓中的原始粒细胞比例相关，并且与HSCT时的高输血量和较差的体能状态相关。根据诊断时、初始治疗后和HSCT前的CPR（低 vs. 高），2年总生存（OS）率分别为67.9% vs. 65.6%（P = 0.477）、72.6% vs. 54.8%（P = 0.022）和73.1% vs. 49.7%（P < 0.001），非复发死亡率（NRM）分别为15.8% vs. 19.0%（P = 0.557）、13.8% vs. 21.5%（P = 0.201）和13.0% vs. 27.6%（P = 0.006）。复发率未观察到显著差异。在多变量分析中，HSCT前的高CPR组与较差的OS（HR = 1.86，95%CI：1.13 - 3.07，P = 0.015）和较高的NRM（HR = 2.52，95%CI：1.26 - 5.04，P = 0.009）相关。HSCT前的CPR与HSCT后的OS和NRM相关。CPR被认为是反映疾病状态和患者状况的标志物，提示了CPR监测的重要性。
