Association between serum albumin and 60-day mortality in Chinese Hakka patients with non-APL acute myeloid leukemia: a retrospective cohort study

Abstract

Background Acute myeloid leukemia (AML) is the main type of adult leukemia, and 60-day mortality is a vital clinical problem that doctors have to face at the begin with treatment. Studies on the association between serum albumin and 60-day mortality from AML (non-APL) are limited. Methods In this retrospective cohort study, ALB was measured after admission in all patients diagnosed with primary AML from Affiliated Ganzhou Hospital of Nanchang University between January 2013 and May 2021. The outcome was all-cause, 60-day mortality. Multivariable Cox regression analyses were performed to calculate the adjusted hazard ratio (HR) and its corresponding 95% confidence interval (CI). Results This study included 394 primary AML patients. The overall 60-day mortality was 28.9% (114/394); it was 43.1% (56/130), 27.5% (36/131), and 16.5% (22/133) for ALB quantile1 (Q, < 34.5 g/L), quantile 2 (Q2, 34.5–38.5 g/L), and quantile 3 (Q3, ≥ 38.6 g/L), respectively (P = 0.001). After adjusting for potential confounders, we found an association between a 6% decrease in 60-day mortality rate and a 1 g/L increase in ALB level (HR = 0.94, 95% CI: 0.89–0.99, P = 0.015), which was associated with 38 and 70% decreases in 60-day mortality rates in Q2 (HR = 0.50, 95% CI: 0.30–0.86, P = 0.012) and Q3 (HR = 0.47, 95% CI: 0.2 5–0.90, P = 0.022), respectively, compared with that in Q1. Similar results were obtained after subgrouping based on an ALB level of 35 g/L (HR = 0.55, 95% CI: 0.34–0.88, P = 0.013). Conclusions Serum albumin was significantly associated with 60-day mortality of primary AML, which has important clinical significance. Further investigation is warranted.

Predictive value of serum albumin levels on cancer survival: a prospective cohort study

“…Tilman Kühn and colleagues found that lower serum albumin levels were significantly associated with increased mortality from breast, prostate, colorectal, and lung cancer (21). A retrospective study also indicated that lower serum albumin levels predicted a higher 60-day mortality rate from acute myeloid leukemia (22). Ali Ayhan et al identified that preoperative albumin level was an independent prognostic factor for epithelial ovarian cancer patients following optimal debulking (23).…”

Serum albumin is associated with the inherent property of acute myeloid leukemia and correlates with patient outcomes

“… 18 Several retrospective studies on AML have demonstrated that a lower serum albumin level before treatment is associated with inferior survival in newly diagnosed AML and relapsed or refractory AML. 19 – 25 Serum albumin levels reflect patients’ nutritional status, which is correlated with chemotherapy tolerance. Lower serum albumin levels indicate a significantly decreased CR rate and lower 60-day survival after the first chemotherapy.…”

“…Lower serum albumin levels indicate a significantly decreased CR rate and lower 60-day survival after the first chemotherapy. 21 , 25 It remains unclear whether the inferior outcomes of patients with lower albumin levels can be explained by the intolerability to chemotherapy or by the more aggressive status of blasts. Previous studies have been limited by small sample sizes and diverse treatment strategies.…”

Electrochemical and Optical Analysis of Various Compositions of Au and Ag Layers for Blood Cancer Prognosis

“…Past studies have shown that AML patients with serum albumin <35 g/L require more intensive care and have lower survival rates. Consequently, prognosis monitoring of blood cancer can be carried out by measuring the concentration of serum albumin in the blood of patients [6,7]. Conventional methods to monitor the condition of blood cancer patients include bone marrow aspiration to evaluate blood cells and diagnose conditions related to the bone marrow of patients [8].…”