Apolipoprotein-A is a potential prognostic biomarker for severe aplastic anemia patients treated with ATG-based immunosuppressive therapy: a single-center retrospective study
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Published:2022-10-04
Issue:1
Volume:21
Page:
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ISSN:1476-511X
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Container-title:Lipids in Health and Disease
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language:en
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Short-container-title:Lipids Health Dis
Author:
Liu Qi,Dong Huijie,Li Yuzhu,Shen Yingying,Hong Yilei,Chen Ying,Liu Shan,Wu Xiaolian,Liu Wenbin,Hu Huijin,Zhao Yuechao,Lin Shenyun,Shen Yiping,Zhou Yuhong,Ye Baodong,Wu Dijiong
Abstract
AbstractBackgroundAnti-thymoglobulin (ATG)-based immunosuppressive treatment (IST) is the standard first-line management for patients with severe AA/very severe AA (SAA/VSAA) and is not suitable for allogeneic stem cell transplantation. The response predictor was not fully investigated.ObjectiveThe present study attempted to explore other characteristics, such as serum lipid changes, during ATG-based IST and analyzed their significance in predicting IST response and survival.MethodsA total of 61 newly diagnosed SAA/VSAA patients who received ATG-based IST were enrolled from January 2011 to June 2019. The blood lipid levels, immunoglobulins, and peripheral T lymphocytes were retrospectively collected, and their correlations with IST response, estimated 8.5-year overall survival (OS) and event-free survival (EFS) were analyzed.ResultsThe overall response (OR)/complete remission (CR) at 3, 6, and 9 months was 24.6%/6.6%, 52.5%/14.8%, and 65.6%/23.0%, respectively. Based on the 9-month response effect, patients were divided into IST-response (IST-R) and IST-nonresponse (IST-NR) groups. The subgroup baseline characteristics showed that the disease severity grade, absolute neutrophil granulocyte count (ANC), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein-A (Apo-A) differed between the IST-R and IST-NR groups. Patients with lower Apo-A (< 1.205 g/L) level pretreatment had a better event-free survival (EFS), and a moderate negative correlation was established between the pretreatment Apo-A and 9-month response (P = 0.004). In addition, the T-cell subset and immunoglobulin analyses showed that the responsive patients had a low serum IgA level, which decreased further after therapy. Additionally, a moderate negative correlation was established between the 3-month IgA and 9-month response (P = 0.006).ConclusionSerum Apo-A is a prognostic biomarker for newly diagnosed < 60-year-old SAA/VSAA patients who received ATG-based IST (registered atchictr.org.cn as # ChiCTR2100052979).
Funder
Zhejiang Scientific Research Fund of Traditional Chinese Medicine National Natural Science Foundation of China Health technology Plan of Zhejiang Province
Publisher
Springer Science and Business Media LLC
Subject
Biochemistry (medical),Clinical Biochemistry,Endocrinology,Endocrinology, Diabetes and Metabolism
Reference37 articles.
1. Camitta BM. Pathogenesis and treatment of aplastic anemia. Rinsho Ketsueki. 1984;25:459–69. 2. Killick SB, Bown N, Cavenagh J, Dokal I, Foukaneli T, Hill A, Hillmen P, Ireland R, Kulasekararaj A, Mufti G, et al. Guidelines for the diagnosis and management of adult aplastic anaemia. Br J Haematol. 2016;172:187–207. 3. Bacigalupo A, Oneto R, Schrezenmeier H, Hochsmann B, Dufour C, Kojima S, Zhu X, Chen X, Issaragrisil S, Chuncharunee S, et al. First line treatment of aplastic anemia with thymoglobuline in Europe and Asia: Outcome of 955 patients treated 2001–2012. Am J Hematol. 2018;93:643–8. 4. Narita A, Muramatsu H, Ichikawa D, Hamada M, Nishikawa E, Suzuki K, Kawashima N, Okuno Y, Nishio N, Hama A, et al. Relationship between plasma rabbit anti-thymocyte globulin concentration and immunosuppressive therapy response in patients with severe aplastic anemia. Eur J Haematol. 2021;107:255–64. 5. Jin JY, Kim DW, Lee JW, Han CW, Min WS, Park CW, Kim CC, Kim DJ, Kim HK, Song HH. Immune suppression therapy in aplastic anemia: influencing factors on response and survival. Korean J Intern Med. 1995;10:25–31.
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