The prognostic value of serum C-reactive protein, ferritin, and albumin prior to allogeneic transplantation for acute myeloid leukemia and myelodysplastic syndromes

Center for International Blood and Marrow Transplantation Research

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Abstract

We sought to confirm the prognostic importance of simple clinically available biomarkers of C-reactive protein, serum albumin, and ferritin prior to allogeneic hematopoietic cell transplantation. The study population consisted of 784 adults with acute myeloid leukemia in remission or myelodysplastic syndromes undergoing unrelated donor transplant reported to the Center for International Blood and Marrow Transplant Research. C-reactive protein and ferritin were centrally quantified by ELISA from cryopreserved plasma whereas each center provided pre-transplant albumin. In multivariate analysis, transplant-related mortality was associated with the pre-specified thresholds of C-reactive protein more than 10 mg/L (P=0.008) and albumin less than 3.5 g/dL (P=0.01) but not ferritin more than 2500 ng/mL. Only low albumin independently influenced overall mortality. Optimal thresholds affecting transplant-related mortality were defined as: Creactive protein more than 3.67 mg/L, log (ferritin), and albumin less than 3.4 g/dL. A 3-level biomarker risk group based on these values separated risks of transplant-related mortality: low risk (reference), intermediate (HR=1.66, P=0.015), and high risk (HR=2.7, P<0.001). One-year survival was 74%, 67% and 56% for low-, intermediate-and high-risk groups. Routinely available pre-transplant biomarkers independently risk-stratify for transplant-related mortality and survival.

Original languageEnglish (US)
Pages (from-to)1426-1433
Number of pages8
JournalHaematologica
Volume101
Issue number11
DOIs
StatePublished - Oct 31 2016

Fingerprint

Myelodysplastic Syndromes
Homologous Transplantation
Ferritins
Acute Myeloid Leukemia
C-Reactive Protein
Blood Proteins
Albumins
Transplants
Mortality
Biomarkers
Apoferritins
Unrelated Donors
Cell Transplantation
Serum Albumin
Multivariate Analysis
Bone Marrow
Enzyme-Linked Immunosorbent Assay
Research
Population

ASJC Scopus subject areas

  • Hematology

Cite this

The prognostic value of serum C-reactive protein, ferritin, and albumin prior to allogeneic transplantation for acute myeloid leukemia and myelodysplastic syndromes. / Center for International Blood and Marrow Transplantation Research.

In: Haematologica, Vol. 101, No. 11, 31.10.2016, p. 1426-1433.

Research output: Contribution to journalArticle

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abstract = "We sought to confirm the prognostic importance of simple clinically available biomarkers of C-reactive protein, serum albumin, and ferritin prior to allogeneic hematopoietic cell transplantation. The study population consisted of 784 adults with acute myeloid leukemia in remission or myelodysplastic syndromes undergoing unrelated donor transplant reported to the Center for International Blood and Marrow Transplant Research. C-reactive protein and ferritin were centrally quantified by ELISA from cryopreserved plasma whereas each center provided pre-transplant albumin. In multivariate analysis, transplant-related mortality was associated with the pre-specified thresholds of C-reactive protein more than 10 mg/L (P=0.008) and albumin less than 3.5 g/dL (P=0.01) but not ferritin more than 2500 ng/mL. Only low albumin independently influenced overall mortality. Optimal thresholds affecting transplant-related mortality were defined as: Creactive protein more than 3.67 mg/L, log (ferritin), and albumin less than 3.4 g/dL. A 3-level biomarker risk group based on these values separated risks of transplant-related mortality: low risk (reference), intermediate (HR=1.66, P=0.015), and high risk (HR=2.7, P<0.001). One-year survival was 74{\%}, 67{\%} and 56{\%} for low-, intermediate-and high-risk groups. Routinely available pre-transplant biomarkers independently risk-stratify for transplant-related mortality and survival.",
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T1 - The prognostic value of serum C-reactive protein, ferritin, and albumin prior to allogeneic transplantation for acute myeloid leukemia and myelodysplastic syndromes

AU - Center for International Blood and Marrow Transplantation Research

AU - Artz, Andrew S.

AU - Logan, Brent

AU - Zhu, Xiaochun

AU - Akpek, Gorgun

AU - Bufarull, Rodrigo Martino

AU - Gupta, Vikas

AU - Lazarus, Hillard M.

AU - Litzow, Mark

AU - Loren, Alison

AU - Majhail, Navneet S.

AU - Maziarz, Richard

AU - McCarthy, Philip

AU - Popat, Uday

AU - Saber, Wael

AU - Spellman, Stephen

AU - Ringden, Olle

AU - Wickrema, Amittha

AU - Pasquini, Marcelo C.

AU - Cookel, Kenneth R.

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