The Prognostic Significance of C-Reactive Protein to Albumin Ratio in Newly Diagnosed Acute Myeloid Leukaemia Patients

Abstract

Background The ratio of C-reactive protein to albumin (CAR) is an inflammatory marker that has been demonstrated to be a simple and reliable prognostic factor in several solid tumours and chronic lymphocytic leukaemia (CLL). However, no studies have investigated the prognostic value of the CAR in patients with acute myeloid leukaemia (AML). Objectives and Methods We retrospectively analysed 212 newly diagnosed non-M3 AML patients. Using the receiver operating characteristic curve (ROC) method, the optimal cut-off value for CAR was determined. We investigated the correlations of the pretreatment CAR levels with clinical characteristics, treatment response of induction chemotherapy, overall survival (OS) and event-free survival (EFS). We also assessed the prognostic value of the CAR compared with other inflammation-based prognostic parameters by the area under the curve (AUC). Results According to the ROC curve, the optimal cut-off value of CAR was 1.015. CAR was associated with age, C-reactive protein (CRP) levels, albumin levels, ferritin levels, bone marrow blast percentage, French-American-British (FAB) classification, immunophenotype and 2017 European Leukemia Net (2017 ELN) risk stratification. Importantly, we found that high CAR was a powerful indicator of a lower complete remission (CR) rate ( p <0.001), worse OS ( p <0.001) and worse EFS ( p <0.001). Subgroup analysis showed that a high CAR was associated with shorter OS and EFS in patients with intermediate risk stratification or those aged ≤65 years or those without haematopoietic stem cell transplantation (HSCT). In the multivariate analysis, the CAR was an independent prognostic factor for OS and EFS. Furthermore, the predictive value of CAR for OS is superior to that of CRP, albumin and GPS in de novo AML patients aged ≤65 years old. Conclusion CAR is a simple and effective prognostic marker in patients with AML. It could be an additional prognostic factor that help further precise the current risk stratification of non-M3 AML, particularly for patients in intermediate risk stratification and those aged ≤65 years and those who did not undergo HSCT.

Advanced lung cancer inflammation index is associated with long-term cardiovascular death in hypertensive patients: national health and nutrition examination study, 1999–2018

“…As mentioned in the introduction, inflammation can accelerate protein breakdown, resulting in a reduction in albumin levels. Moreover, inflammation can also induce insulin resistance, diminish appetite, and hinder the absorption of nutrients, ultimately leading to weight loss ( Yoon et al, 2016 ; Guescini et al, 2017 ; Merker et al, 2020 ; Aldhwayan et al, 2022 ; Dou et al, 2022 ). Hence, relying solely on a single inflammatory marker to evaluate the mortality risk in patients with hypertension may not provide sufficiently accurate results.…”

Pre-transplant CRP–albumin ratio as a biomarker in patients receiving haploidentical allogeneic hematopoietic transplantation: Developing a novel DRCI-based nomogram

“…Because the majority of pertinent publications are single-center studies, there is currently no consensus conclusion on whether these cutoffs apply to the prognosis of all patients with HSCT. In other investigations, patients in the high CAR group experienced more aggressive tumor behavior ( 38 )and a shorter survival time ( 37 , 39 ). Determining the ideal cutoff of CAR is crucial for its clinical application, and this research might offer a better option for identifying the optimal cutoff of CAR.…”

Annona muricata Leaf Extract Modulates Chloramphenicol-Induced Lymphoma in Female Wistar Rats

“…Results of cardiac markers (TP-I and MB) and cancer markers (CRP, CEA, and AFP) evaluated in this study were very significant and suggests that the chloramphenicol administered did not only induce lymphoma in the blood but also affected the physiological function of the heart. CRP is a simple and effective prognostic marker in patients with acute myeloid leukaemia 36 and has been reported to be a prognostic indicator in a variety of haematologic malignancies 37 and solid tumours. 38 Its elevations in the plasma has been associated with shorter survival and development of second cancer in patients with chronic lymphocytic leukaemia.…”