| Objective: The purpose of this study was to analyze the relationship between serum ferritin level（SF）and clinical characteristics such as age,sex,disease classification,clinical manifestations before chemotherapy,laboratory indicators,chromosome karyotype,gene mutations,prognosis stratification,chemotherapy-related adverse reactions and the efficacy of initial chemotherapy in newly diagnosed adult patients with acute Myelogenous leukemia（AML）.Methods: Retrospectively collected the clinical data of 103 newly diagnosed adult patients with AML（non-acute promyelocytic leukemia）who were treated at the First Hospital of Lanzhou University from December 2016 to October 2021,including age,sex,disease classification,clinical manifestations before chemotherapy such as fever,infection,bleeding,SF,lactate dehydrogenase（LDH）,newly diagnosed white blood cells（WBC1）,newly diagnosed red blood cells（RBC1）,newly diagnosed hemoglobin（HGB1）,newly diagnosed platelets（PLT1）,white blood cells in myeloid suppression after chemotherapy（WBC2）,chromosome karyotype,gene mutations,prognosis stratification,chemotherapy-related adverse reactions such as fever,infection,bleeding,hepatorenal toxicity,the duration of agranulocytosis after chemotherapy,and the efficacy of initial chemotherapy such as the state of disease remission and minimal residual disease（MRD）.The above data were statistically analyzed by plotting the ROC curve to determine the optimal cut-off value for predicting the complete remission（CR）state in newly diagnosed adult AML patients,and the patients were divided into the low SF group（SF < 509.5ng/m L）and the high SF group（SF≥ 509.5ng/m L）with the optimal cut-off value as the boundary for statistical analysis of the above data.Results:1.The median SF level of 103 newly diagnosed adult AML patients was 618.3（345.1 ～ 1 279）ng/ m L,significantly higher than the normal level.2.Among the 103 newly diagnosed adult AML patients,there were 54 males（52.4%）and 49 females（47.6%）,including 14 males（34.1%）and 27 females（65.9%）in the low SF group,40 males（64.5%）and 22 females（35.5%）in the high SF group.The proportion of males in the high SF group was higher than that in the low SF group.It was about twice that of the low SF group,and there was significant gender difference between the different groups（P=0.003）.3.The infection rate before chemotherapy in the high SF group（41.9%）was higher than that in the low SF group（7.3%）,and the difference between groups was statistically significant（P=0.000）.But there were no differences in fever and bleeding before chemotherapy（P=0.900;P = 0.772）.4.There were significant differences in RBC1 and HGB1 counts among groups with different SF levels.RBC1 and HGB1 counts in the high SF group were significantly lower than those in the low SF group,but there were no significant differences in PLT1,WBC1,WBC2 and LDH between the two groups.5.There were no statistical differences in age,disease classification,chromosome karyotype,TP53 mutation,WT1 mutation,KIT mutation,FLT3 mutation and NPM1 mutation among groups with different SF level,but the mutation rate of CEBPA in low SF group（34.1%）was significantly higher than that in high SF group（14.5%）,the mutation rate of ASXL1 in low SF group（9.8%）was significantly lower than that in high SF group（30.6%）,the differences were statistically significant（P=0.019;P =0.013）.6.The proportion of patients with good prognosis in the low SF group（29.7%）was higher than that in the high SF group（4.9%）,and the proportion of patients with poor prognosis（27%）was lower than that in the high SF group（54.1%）.The proportion of patients with moderate prognosis in the different groups was similar（low SF group:high SF group =43.2% : 41%）.The differences were statistically significant（P=0.001）.7.The duration of agranulocytosis after chemotherapy was（20.48±5.304）days in the high SF group and（17.56±3.502）days in the low SF group.The duration of agranulocytosis after chemotherapy in the high SF group was longer than that in the low SF group,and the difference was statistically significant（P=0.041）.However,there were no differences in fever,infection,bleeding and hepatorenal toxicity after the first induction of remission.8.The CR rate of the high SF group（47.5%）was lower than that of the low SF group（85%）after the first induction of remission,and the difference was significant.（P=0.000）.The positive rate of MRD in the high SF group（34.6%）was higher than that in the low SF group（7.1%）,but there was no significant difference（P=0.070）.Conclution:1.Male patients with high SF were significantly more than female patients,and the infection rate of patients with high SF was significantly higher than those in patients with low SF before chemotherapy,RBC1 and HGB1 counts were significantly lower than those in patients with low SF.2.SF level was not associated with age,disease classification,PLT1,WBC1,WBC2,LDH,chromosome abnormality,TP53 mutation,WT1 mutation,KIT mutation,FLT3 mutation,and NPM1 mutation in newly diagnosed adult AML patients.However,the mutation rate of ASXL1 was higher in patients with high SF and the mutation rate of CEBPA mutation rate was higher in patients with low SF.3.There was no difference in fever and bleeding before chemotherapy and in fever,infection,bleeding and hepatorenal toxicity after chemotherapy among newly diagnosed adult AML patients with different SF level.However,The duration of agranulocytosis after chemotherapy in patients with high SF was significantly longer than that in patients with low SF.High SF level can reduce the efficacy of initial chemotherapy in newly diagnosed adult AML patients,and can be used as a risk factor to evaluate the efficacy of initial chemotherapy and prognosis in newly diagnosed adult AML patients. |
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