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

Albumin-to-fibrinogen ratio is an independent prognostic parameter in de novo non-M3 acute myeloid leukemia

Inflammation and nutrition related proteins participate in the development of acute myeloid leukemia (AML). It has been reported that the albumin-to-fibrinogen ratio (AFR) could serve as a prognostic indicator in patients with malignancy, but the precise relevance of AML is unclear. This study aimed to evaluate the effect of AFR on survival prognosis in patients with AML. We analyzed 227 patients newly diagnosed with non-M3 AML. AFR was calculated as albumin divided by fibrinogen. Based on the cutoff point from X-tile program, patients were divided into AFR-high (38.8%) and AFR-low (61.2%) groups. AFR-low group showed a poorer complete remission rate (P < 0.001) and median time to relapse (P = 0.026), while the mortality was higher (P = 0.009) than AFR-high ones. According to the log-rank test, AFR-low group had shorter OS (P < 0.001) and DFS (P = 0.034). Multivariate analysis identified AFR, ELN risk, bone marrow transplant, and hemoglobin as independent prognostic variables associated with OS. A visualized nomogram for predicting OS was performed. The C-index (0.75), calibration plots, and decision curve analyses of new model showed better discrimination, calibration, and net benefits than the ELN risk model. The time-dependent receiver operating characteristic (ROC) curve of 1-, 2-, and 3-year also functioned well (AUC, 0.81, 0.93 and 0.90, respectively). Our study provided a comprehensive view of AFR which could be an independent prognostic indicator in AML patients. The prognostic model utilized readily available information from ordinary clinical practice to improve predictive performance, identify risks, and assist in therapeutic decision-making.

The fibrinogen-albumin ratio as a novel prognostic factor for elderly patients with osteosarcoma

To analyze the prognostic value of fibrinogen-albumin ratio (FAR) in predicting the overall survival in elderly osteosarcoma patients. One hundred nineteen elderly osteosarcoma patients (> 40 years old) from 2 centers were retrospectively reviewed and analyzed. The cutoff values of the biomarker were calculated via receiver operating characteristic curves, and the cohort was divided into high FAR group and low FAR group. The association between the FAR and clinical-pathological parameters was analyzed. And the prognosis of elderly osteosarcoma patients and the potential risk factors were analyzed using Kaplan-Meier method and Cox proportional hazards model. Finally, a clinical nomogram was constructed, and its predictive capacity was verified. According to receiver operating characteristic results, the cutoff value for FAR was 0.098, and the enrolled patients were divided into the low FAR group and high FAR group. The FAR was significantly correlated with several clinical-pathological characteristics, including age, tumor size, tumor stage, recurrence, and metastasis. Moreover, the multivariate Cox analyses results showed that the FAR, pathological fracture, and metastasis were independent risk factors for overall survival in elderly osteosarcoma patients. The predictive nomogram was subsequently constructed, representing satisfactory predictive performance for prognosis in elderly patients with osteosarcoma. The FAR value is a promising indicator for elderly osteosarcoma patients, which is correlated with the various clinical characteristics and prognosis. A clinical nomogram integrating FAR and other clinical indicators is a convenient and available tool to assess the prognosis and manage the individualized and precise treatment of elderly patients with osteosarcoma.

Analysis of the Clinical Efficacy of Azacytidine + Venetoclax in the Treatment of Elderly Patients with Relapsed Refractory Acute Myeloid Leukemia

Objective

To explore the clinical efficacy of azacytidine + venetoclax in the treatment of elderly patients with relapsed refractory acute myeloid leukemia (AML).

Method

The present study included 20 elderly patients with relapsed refractory AML from January 2019 to January 2021. These patients were randomized into treatment groups (n = 10, azacytidine alone) and control groups (n = 10, azacytidine + venetoclax) by a random number table. The differences in efficacy, adverse reactions, hematology parameters, and immune functions in elderly patients with relapsed refractory AML in two groups were analyzed.

Results

The total efficiency for elderly patients with relapsed refractory AML was 90.00% and significantly higher than that in the control group (40.00%), P < 0.05; PLT and WBC after treatment in the treatment group were significantly higher than those in the control group, and Hb was significantly lower than in the control group, P < 0.05; CD4+, CD3+, and CD4+/CD8+ after treatment in both groups were significantly lower than those before treatment, P < 0.05; CD4+, CD3+, and CD4+/CD8+ after treatment were not significantly different between the two groups, P > 0.05; the incidences of adverse reactions were not significantly different between the two groups, P > 0.05.

Conclusion

Azacytidine + venetoclax in the treatment of elderly patients with relapsed refractory AML could improve efficacy and hematology parameters with high safety, which is of great significance.