Prognostic significance of the CFA ratio for newly diagnosed acute myeloid leukemia: A multicenter retrospective study

Author:

Sakuma Takayuki1ORCID,Fujisawa Shin2,Tanaka Masatsugu3,Hagihara Maki1,Fujita Hiroyuki4,Fujimaki Katsumichi5,Katsuki Kengo2,Akimoto Masahiro2,Tanaka Marika1,Matsumura Ayako2,Teshigawara Haruka1,Suzuki Taisei5,Teranaka Hiroshi1,Nakajima Yuki2,Miyazaki Takuya2,Tachibana Takayoshi3,Matsumoto Kenji1,Sakai Rika3,Kanamori Heiwa3,Nakajima Hideaki1

Affiliation:

1. Department of Hematology and Clinical Immunology Yokohama City University School of Medicine Yokohama Japan

2. Department of Hematology Yokohama City University Medical Center Yokohama Japan

3. Department of Hematology and Medical Oncology Kanagawa Cancer Center Yokohama Japan

4. Department of Hematology Saiseikai Yokohamashi Nanbu Hospital Yokohama Japan

5. Department of Hematology Fujisawa City Hospital Fujisawa Japan

Abstract

AbstractThe CFA ratio, calculated using pretreatment C‐reactive protein (CRP), fibrinogen, and albumin levels (CRP × fibrinogen/albumin), was previously reported to be a significant prognostic factor for acute myeloid leukemia (AML). This multicenter retrospective study evaluated the prognostic value of the CFA ratio in 328 adult patients with newly diagnosed AML from April 2000 to March 2018. The median age was 49.5 years (range, 15–75 years), and 60.7% of the population were males. According to the European LeukemiaNet (ELN) risk classification, 67 patients (20.4%) were in the favorable‐risk group, 197 patients (60.1%) in the intermediate‐risk group, and 58 patients (17.7%) in the adverse‐risk group. The median CFA ratio was 1.07 (0–67.69). Based on the calculated cutoff CFA ratio of 1.44, the cohort included 176 and 152 patients with low and high CFA ratios, respectively. At a median follow‐up of 91.2 months, the 7‐year overall survival (OS) and disease‐free survival (DFS) rates were 51.2% and 48.6%, respectively, in the overall cohort. The 7‐year OS rates were 61.7% and 39.0% in the low and high CFA ratio groups, respectively (p < 0.001). The 7‐year DFS rates were 58.1% and 37.0% in the low and high CFA ratio groups, respectively (p = 0.004). In univariate analysis, age ≥50 years, male sex, ELN risk class, and comorbidities were associated with poor OS. Age, ELN risk class, comorbidities, and high CFA ratio were associated with poor OS in multivariate analysis. Subgroup analysis revealed that the CFA ratio was significant in the intermediate and adverse ELN risk classes. These findings indicate the prognostic significance of the CFA ratio in AML.

Publisher

Wiley

Subject

Cancer Research,Oncology,Hematology,General Medicine

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