Circulating miR-181a-3p, ATR, and HMGB-1 as Integrated Predictors of Induction Blast Clearance in Adults with Acute Myeloid Leukemia.

Q2 Medicine

Asian Pacific Journal of Cancer Prevention Pub Date : 2026-09-01 DOI:10.31557/APJCP.2026.27.9.3479

Resti Mulya Sari, Lyana Setiawan, Damai Santosa, Melva Louisa, Syarifah Dewi, Ikhwan Rinaldi, Noorwati Sutandyo, Anderson Cenweikiawan

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引用次数: 0

Abstract

Methods: This study included 71 adult patients with newly diagnosed AML who received standard "7+3" induction chemotherapy. Baseline circulating miR-181a-3p and miR-181b-5p levels were quantified using quantitative real-time polymerase chain reaction, while ATM, ATR, and HMGB-1 protein levels were measured using enzyme-linked immunosorbent assay. Induction blast clearance was defined as a post-induction bone marrow blast count of <5%. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values. Associations were evaluated using Spearman correlation and relative risk (RR) with 95% confidence intervals.

Results: Circulating miR-181a-3p demonstrated limited discriminatory performance (AUC = 0.564), while HMGB-1 showed modest performance (AUC = 0.615). Using ROC-derived cut-off values, low baseline miR-181a-3p expression was associated with a significantly higher likelihood of achieving induction blast clearance in monocytic AML (FAB M4-M5) (RR = 2.33, 95% CI: 1.18-4.63, p = 0.015), but not in non-monocytic subtypes. Higher ATR (RR = 1.53, 95% CI: 0.99-2.38, p = 0.047) and HMGB-1 levels (RR = 1.61, 95% CI: 1.04-2.50, p = 0.031) were also associated with improved induction response. Circulating miR-181a-3p correlated with baseline bone marrow blast percentage, suggesting its potential as a surrogate marker for leukemic burden.

Conclusion: Circulating miR-181a-3p, ATR, and HMGB-1 are associated with induction blast clearance in AML, with lineage-specific effects observed for miR-181a-3p. Although the individual biomarkers demonstrated limited discriminatory performance, their integration may provide clinically relevant insights into early treatment response.

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循环miR-181a-3p、ATR和HMGB-1作为成人急性髓性白血病诱导细胞清除的综合预测因子

方法：本研究纳入71例接受标准“7+3”诱导化疗的成年新诊断AML患者。采用实时定量聚合酶链反应测定基线循环miR-181a-3p和miR-181b-5p水平，采用酶联免疫吸附法测定ATM、ATR和HMGB-1蛋白水平。结果：循环miR-181a-3p表现出有限的区分性能（AUC = 0.564），而HMGB-1表现出适度的性能（AUC = 0.615）。使用roc衍生的临界值，低基线miR-181a-3p表达与单核细胞AML （FAB m1 - m5）中实现诱导细胞清除的可能性显著增加相关（RR = 2.33, 95% CI: 1.18-4.63, p = 0.015），但在非单核细胞亚型中则不然。较高的ATR （RR = 1.53, 95% CI: 0.99-2.38, p = 0.047）和HMGB-1水平（RR = 1.61, 95% CI: 1.04-2.50, p = 0.031）也与诱导反应的改善有关。循环miR-181a-3p与基线骨髓母细胞百分比相关，提示其可能作为白血病负担的替代标记物。结论：循环miR-181a-3p、ATR和HMGB-1与AML诱导母细胞清除相关，并观察到miR-181a-3p具有谱系特异性作用。尽管个体生物标志物表现出有限的歧视性表现，但它们的整合可能为早期治疗反应提供临床相关的见解。

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

Asian Pacific Journal of Cancer Prevention 医学-肿瘤学

CiteScore

2.80

自引率

0.00%

发文量

779

审稿时长

3 months

期刊介绍： Cancer is a very complex disease. While many aspects of carcinoge-nesis and oncogenesis are known, cancer control and prevention at the community level is however still in its infancy. Much more work needs to be done and many more steps need to be taken before effective strategies are developed. The multidisciplinary approaches and efforts to understand and control cancer in an effective and efficient manner, require highly trained scientists in all branches of the cancer sciences, from cellular and molecular aspects to patient care and palliation. The Asia Pacific Organization for Cancer Prevention (APOCP) and its official publication, the Asia Pacific Journal of Cancer Prevention (APJCP), have served the community of cancer scientists very well and intends to continue to serve in this capacity to the best of its abilities. One of the objectives of the APOCP is to provide all relevant and current scientific information on the whole spectrum of cancer sciences. They aim to do this by providing a forum for communication and propagation of original and innovative research findings that have relevance to understanding the etiology, progression, treatment, and survival of patients, through their journal. The APJCP with its distinguished, diverse, and Asia-wide team of editors, reviewers, and readers, ensure the highest standards of research communication within the cancer sciences community across Asia as well as globally. The APJCP publishes original research results under the following categories: -Epidemiology, detection and screening. -Cellular research and bio-markers. -Identification of bio-targets and agents with novel mechanisms of action. -Optimal clinical use of existing anti-cancer agents, including combination therapies. -Radiation and surgery. -Palliative care. -Patient adherence, quality of life, satisfaction. -Health economic evaluations.