The prognostic value of the Fibrinogen-Albumin Ratio Index in patients with myelodysplastic syndrome and acute myeloid leukemia with myelodysplasia-related changes treated with azacitidine
- 1 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Annals of Hematology
- Vol. 100 (4), 953-957
- https://doi.org/10.1007/s00277-021-04440-z
Abstract
Inflammation is a major hallmark of several cancers. The present study evaluated the prognostic value of the Fibrinogen-Albumin Ratio Index (FARI) at the diagnosis in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) treated with azacitidine (AZA). A retrospective study was conducted in a single cohort of 99 patients with de novo MDS and AML-MRC who were treated with AZA between May 2011 and June 2019 in our hospital. Plasma fibrinogen and serum albumin levels were measured before the start of AZA treatment. A total of 99 patients were included in the analysis. The optimal cut-off value of FARI for predicting the 1-year overall survival (OS) was determined by a receiver operating characteristic (ROC) analysis to be 0.079. A total of 59 (60%) and 40 (40%) patients had an FARI ≥0.079 (high-FARI group) and < 0.079 (low-FARI group), respectively. The high-FARI patients had a significantly shorter OS than low-FARI patients (1-year OS, 35.6% vs. 77.5%, p < 0.001). In a multivariate analysis, parameters with independent adverse significance for the OS were a high FARI (≥0.079) (hazard ratio (HR) 2.41, 95% confidence interval (CI), 1.36–4.29; p = 0.006), and Revised-International Prognostic Scoring System (IPSS-R) very high (HR 1.483, 95% CI, 1.12–1.963, p = 0.006). A high FARI was found to be associated with a poor outcome in MDS and AML-MRC patients treated with AZA, and FARI was an independent prognostic factor for the OS in these patients. Further internal and external validations are needed to clarify the prognostic role of the FARI for MDS and AML-MRC patients.Keywords
This publication has 20 references indexed in Scilit:
- Safety and efficacy of azacitidine in elderly patients with intermediate to high-risk myelodysplastic syndromesTherapeutic Advances in Hematology, 2016
- Increased fibrinogen levels at diagnosis are associated with adverse outcome in patients with acute myeloid leukemiaHematological Oncology, 2016
- The clinical significance of fibrinogen plasma levels in patients with diffuse large B cell lymphomaJournal of Clinical Pathology, 2015
- Circulating fibrinogen is a prognostic and predictive biomarker in malignant pleural mesotheliomaBritish Journal of Cancer, 2014
- Hypoalbuminemia is an independent prognostic factor for overall survival in myelodysplastic syndromesAmerican Journal of Hematology, 2012
- Risk stratification based on both disease status and extra-hematologic comorbidities in patients with myelodysplastic syndromeHaematologica, 2010
- Immunity, Inflammation, and CancerCell, 2010
- Inflaming metastasisNature, 2008
- Fibrinogen and FibrinAdvances in protein chemistry, 2005
- Inflammation and cancerNature, 2002