title: Severe hypoalbuminemia at day 90 predicts worse nonrelapse mortality and overall survival after allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia and myelodysplastic syndrome.
abstract: Because patients who undergo allogeneic hematopoietic cell transplantation (allo-HCT) remain in the vicinity of the transplant center for approximately 90 days posttransplantation, identifying prognostic factors to determine those at immediate higher risk of mortality is essential. A normal serum albumin level generally denotes healthiness. We evaluated the prognostic significance of day 90 hypoalbuminemia (and other clinical, pharmacologic, and laboratory variables) in 163 patients, median age 48 years (range, 19-69 years), who underwent allo-HCT for acute myelogenous leukemia (n = 124) or myelodysplastic syndrome (n = 39). Day 90 hypoalbuminemia (serum albumin <3.0 g/dL) was associated with worse nonrelapse mortality (NRM) and poor overall survival (OS). The estimated 1- and 2-year cumulative incidence rates of NRM were 48% and 52%, respectively, and the corresponding OS rates were 7% and 3%. Serum albumin level <3.0 g/dL and Karnofsky score <80 at day 90 were strong independent predictors of worse NRM and OS in multivariate analysis. These results support day 90 hypoalbuminemia as an adverse prognostic marker for NRM and OS after allo-HCT for acute myelogenous leukemia and myelodysplastic syndrome.
authors.affiliation: Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA. Mohamed.Kharfan-Dabaja@moffitt.org
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Kharfan-Dabaja
authors.forename: Julio C
authors.initials: JC
authors.lastname: Chavez
authors.forename: Daohai
authors.initials: D
authors.lastname: Yu
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhu
authors.forename: Eduardo I
authors.initials: EI
authors.lastname: Fernandez-Vertiz
authors.forename: Janelle
authors.initials: J
authors.lastname: Perkins
authors.forename: Jamie
authors.initials: J
authors.lastname: Shapiro
authors.forename: Ryan
authors.initials: R
authors.lastname: Bookout
authors.forename: Lia
authors.initials: L
authors.lastname: Perez
authors.forename: Hugo F
authors.initials: HF
authors.lastname: Fernandez
authors.forename: Rami S
authors.initials: RS
authors.lastname: Komrokji
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lancet
authors.forename: Linda
authors.initials: L
authors.lastname: Brand
authors.forename: Teresa
authors.initials: T
authors.lastname: Field
authors.forename: Ernesto
authors.initials: E
authors.lastname: Ayala
authors.forename: William
authors.initials: W
authors.lastname: Janssen
authors.forename: Alan F
authors.initials: AF
authors.lastname: List
authors.forename: Claudio
authors.initials: C
authors.lastname: Anasetti
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood* / Q000209:etiology; D017567:Karnofsky Performance Status; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D016019:Survival Analysis; D013997:Time Factors; D014184:Transplantation, Homologous; D055815:Young Adult