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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

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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.

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Authors and Affiliations

  1. Department of Hematology, Yokohama Municipal Citizen’s Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan

    Masahiro Akimoto, Aki Sakurai, Yuriko Nishiyama-Fujita, Chisako Ito, Yoshinobu Aisa & Tomonori Nakazato

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  1. Masahiro Akimoto
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  2. Aki Sakurai
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  3. Yuriko Nishiyama-Fujita
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  4. Chisako Ito
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  5. Yoshinobu Aisa
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  6. Tomonori Nakazato
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Correspondence to Tomonori Nakazato.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the patients. The study was approved by the Ethics Committee of Yokohama Municipal Citizen’s Hospital.

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Akimoto, M., Sakurai, A., Nishiyama-Fujita, Y. et al. 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. Ann Hematol 100, 953–957 (2021). https://doi.org/10.1007/s00277-021-04440-z

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  • DOI: https://doi.org/10.1007/s00277-021-04440-z

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