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Abstract
Acute myeloid leukemia (AML) patients older than 65 years have a poor prognosis. Recently, CAR (C-reactive-protein/albumin ratio) has been actively reported as a prognostic index reflecting the nutritional and inflammatory status of elderly patients with solid tumors, but the usefulness of this index as a prognostic indicator in transplant-ineligible elderly AML patients has not been investigated. We studied genetic alterations and CARs in 188 newly diagnosed AML patients aged 65 years or older who were treated in a multicenter setting and had treated without HSCT. Both NCCN 2017 risk group, reflecting the genetic component of the tumor, and CAR, reflecting the inflammatory and nutritional status of the patient, successfully stratified the overall survival (OS) of the patients (2-year OS; CAR low vs high, 42.3% vs 17.8%, P < 0.001). Furthermore, in multivariate analysis, NCCN 2017 poor group and high CAR were extracted as independent poor prognostic factors predicting 2-year OS in the current study. We found, for the first time, that CAR at diagnosis predicted the prognosis of elderly patients with newly diagnosed AML treated without HSCT.
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1 Hokkaido University, Department of Hematology, Faculty of Medicine, Sapporo, Japan (GRID:grid.39158.36) (ISNI:0000 0001 2173 7691)
2 Sapporo Hokuyu Hospital, Department of Hematology, Sapporo, Japan (GRID:grid.415262.6) (ISNI:0000 0004 0642 244X)
3 Sapporo City General Hospital, Department of Hematology, Sapporo, Japan (GRID:grid.415261.5) (ISNI:0000 0004 0377 292X)
4 Hakodate Municipal Hospital, Department of Hematology, Hakodate, Japan (GRID:grid.413530.0) (ISNI:0000 0004 0640 759X)
5 Tonan Hospital, Department of Hematology, Sapporo, Japan (GRID:grid.417164.1) (ISNI:0000 0004 1771 5774)
6 Japanese Red Cross Kitami Hospital, Department of Hematology, Kitami, Japan (GRID:grid.417164.1)
7 Aiiku Hospital, Blood Disorders Center, Sapporo, Japan (GRID:grid.417164.1)
8 Teine Keijinkai Hospital, Department of Hematology, Sapporo, Japan (GRID:grid.416933.a) (ISNI:0000 0004 0569 2202)
9 Kin-Ikyo Chuo Hospital, Department of Hematology, Sapporo, Japan (GRID:grid.415234.5) (ISNI:0000 0004 0377 9187)
10 Kushiro Rosai Hospital, Department of Hematology, Kushiro, Japan (GRID:grid.415582.f) (ISNI:0000 0004 1772 323X)
11 Asahikawa City Hospital, Department of Hematology, Asahikawa, Japan (GRID:grid.413947.c) (ISNI:0000 0004 1764 8938)
12 Hokkaido Cancer Center, Department of Hematology, Sapporo, Japan (GRID:grid.415270.5)
13 Obihiro Kosei General Hospital, Department of Hematology, Obihiro, Japan (GRID:grid.416691.d) (ISNI:0000 0004 0471 5871)
14 Sapporo Kosei General Hospital, Department of Hematology, Sapporo, Japan (GRID:grid.415268.c) (ISNI:0000 0004 1772 2819)
15 Aiiku Hospital, Blood Disorders Center, Sapporo, Japan (GRID:grid.39158.36)