Clinical significance of plasma endostatin in acute myeloid leukemia/myelodysplastic syndrome.
BACKGROUND
Endostatin, a C-terminal fragment of collagen XVIII, is an endogenous angiogenesis inhibitor. While endostatin is being investigated for its usefulness in treating solid tumors, its significance in hematologic malignancies is unknown.


METHODS
The authors evaluated plasma endostatin (PE) levels using an enzyme linked immunoassay in 71 patients with acute myeloid leukemia (AML) and 43 patients with myelodysplastic syndrome (MDS), and correlated PE with various clinical parameters.


RESULTS
There was no significant difference in the median PE level between AML/MDS patients and the normal controls. Nevertheless, patients who achieved complete remission (CR) had a significantly lower median PE level compared to those who did not. In multivariate analysis, PE was found to be a significant (P = 0.03) predictor of overall survival (OS) with adjustment of the other baseline covariates, including patient age, history of antecedent hematologic disorders, and the use of protective environments. The prognostic value of PE was also evaluated by dividing MDS/AML patients into high and low PE groups using the median PE level of normal controls as the cut-off. The authors found that patients in the high PE group survived for a significantly shorter time than those patients in the low PE group.


CONCLUSIONS
PE is a useful prognostic predictor of CR and OS for AML/MDS patients. The mechanism underlying the association between high PE and poor clinical outcome is unclear, although it may be related to the possible PE reflection of tumor burden.
Lai
Raymond
R
Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.
Estey
Elihu
E
Shen
Yu
Y
Despa
Simona
S
Kantarjian
Hagop
H
Beran
Miloslav
M
Maushouri
Taghi
T
Quackenbuch
Robert C
RC
Keating
Micheal
M
Albitar
Maher
M
D000208:Acute Disease; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003094:Collagen / Q000097:blood*; D043170:Collagen Type XVIII; D043169:Endostatins; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007951:Leukemia, Myeloid / Q000097:blood* / Q000188:drug therapy; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000188:drug therapy; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D016019:Survival Analysis
D000970:Antineoplastic Agents; D043170:Collagen Type XVIII; D043169:Endostatins; D010446:Peptide Fragments; D003094:Collagen