诱导化疗时外周血原始细胞清除时间和初诊时白蛋白水平与急性髓系白血病患者基因突变及预后之间的关系.

Objective To investigate the relationship between peripheral blood blast clearance (PBBC) time during induction chemotherapy and albumin (ALB) level at diagnosis and genetic mutation and prognosis in acute myeloid leukemia patients (AML) . Methods Clinical data of 175 AML patients initially diagnosed from January 2017 to May 2023 at the Second Affiliated Hospital of Kunming Medical University were collected for a retrospective analysis. ROC curve was used to determine the optimal cut-off value of PBBC as 6.5 days. PBBC ≤ 6.5 days were classified as the Peripheral Blood Primitive Blood Cell Short-Term Clearance Group (EBC), and PBBC > 6.5 days were classified as the Peripheral Blood Primitive Blood Cell Long-Term Clearance Group (DBC) . A simple prognostic model was established based on PBBC and ALB at initial diagnosis, dividing patients into groups a, b, and c: group A (PBBC ≤ 6.5 d, ALB > 34.45 g/L, no risk factors), group b (PBBC > 6.5 d, ALB > 34.45 g/L or PBBC ≤ 6.5 d, ALB ≤ 34.45 g/L, 1 risk factor), group c (PBBC > 6.5 d, ALB ≤ 34.45 g/L, 2 risk factors) . Genetic mutations and OS were compared among the three groups of patients; differences in various parameters were evaluated using t-test and chi-squared test or rank sum test, and survival analysis was performed using the Kaplan-Meier method. Results COX regression analysis showed that PBBC and ALB were independent factors affecting prognosis, with statistical significance (P < 0.05) . Comparison of OS among groups revealed median OS values of not reached, 1.86 a, and 0.93 a, respectively (a vs. b group, P < 0.001; a vs. c group, P < 0.001; b vs. c group, P = 0.001), with statistically significant differences indicating that the OS and PFS of the no-risk group were better than those with 1 to 2 risk factors. It was found that CEBPA double mutation and NPM1 gene mutation among the three groups were not statistically significant (P > 0.05), but C-KIT gene mutation was statistically significant (P < 0.05) . Conclusion PBBC and ALB are independent risk factors for the prognosis of AML patients. A simple prognostic model composed of PBBC and ALB can provide a basis for the selection of precise and personalized induction chemotherapy regimens, and provide reference for determining gene mutations and prognosis in newly diagnosed AML patients. [ABSTRACT FROM AUTHOR]