Association of Pretreatment Serum Indirect Bilirubin Levels With Prognostic and Therapeutic Value in Patients With Newly Diagnosed Acute Myeloid Leukemia

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-01-27 DOI:10.1002/cam4.70572

Chunfang Kong, Linhui Hu, Ling Zhang, Hongbo Cheng, Qilin Lu, Anna Li, Bo Ke, Wenting Cui, Huixia Zhang, Mei Wu, Qingqing Zhu, Chenghao Jin, Li Yu

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Abstract

Background

Bilirubin has anti-inflammatory, antioxidant, and anti-cancer properties, with an inverse relationship between its levels and cancer risk and prognosis. However, the prognostic value of serum bilirubin in acute myeloid leukemia (AML) remains uncertain.

Methods

This retrospective study analyzed pretreatment serum total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) in 284 AML patients and 316 healthy controls. The prognostic significance of serum bilirubin levels was determined using the Kaplan–Meier method and Cox proportional hazards model.

Results

Pretreatment TBIL and IBIL levels were significantly lower in AML patients compared to controls. TBIL and IBIL levels were significantly higher in the CR/CRh/CRi group than in the non-CR/CRh/CRi group and increased significantly after chemotherapy. Elevated pretreatment TBIL and IBIL were associated with longer overall survival (OS) (p < 0.05) and progression-free survival (PFS) (p < 0.05). Pretreatment IBIL was an independent prognostic factor for OS (hazard ratio [HR], 0.47; 95% confidence interval [CI] 0.28–0.79; p < 0.05) and PFS (HR, 0.53; 95% CI 0.33–0.85; p < 0.05).

Conclusion

Elevated pretreatment IBIL levels are correlated with improved OS and PFS, acting as an independent favorable prognostic indicator for AML.

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新诊断急性髓性白血病患者治疗前血清间接胆红素水平与预后和治疗价值的关系

背景：胆红素具有抗炎、抗氧化和抗癌特性，其水平与癌症风险和预后呈反比关系。然而，血清胆红素在急性髓性白血病（AML）中的预后价值仍不确定。方法：回顾性分析284例AML患者和316例健康对照者预处理前血清总胆红素（TBIL）、直接胆红素（DBIL）和间接胆红素（IBIL）水平。采用Kaplan-Meier法和Cox比例风险模型确定血清胆红素水平的预后意义。结果：与对照组相比，AML患者治疗前TBIL和IBIL水平明显降低。CR/CRh/CRi组TBIL和IBIL水平明显高于非CR/CRh/CRi组，化疗后显著升高。升高的预处理TBIL和IBIL与更长的总生存期（OS）相关(p结论：升高的预处理IBIL水平与改善的OS和PFS相关，是AML的一个独立的有利预后指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.