title: Uric acid and the prediction models of tumor lysis syndrome in AML.
abstract: We investigated the ability of serum uric acid (SUA) to predict laboratory tumor lysis syndrome (LTLS) and compared it to common laboratory variables, cytogenetic profiles, tumor markers and prediction models in acute myeloid leukemia patients. In this retrospective study patients were risk-stratified for LTLS based on SUA cut-off values and the discrimination ability was compared to current prediction models. The incidences of LTLS were 17.8%, 21% and 62.5% in the low, intermediate and high-risk groups, respectively. SUA was an independent predictor of LTLS (adjusted OR 1.12, CI95% 1.0-1.3, p = 0.048). The discriminatory ability of SUA, per ROC curves, to predict LTLS was superior to LDH, cytogenetic profile, tumor markers and the combined model but not to WBC (AUCWBC 0.679). However, in comparisons between high-risk SUA and high-risk WBC, SUA had superior discriminatory capability than WBC (AUCSUA 0.664 vs. AUCWBC 0.520; p <0.001). SUA also demonstrated better performance than the prediction models (high-risk SUAAUC 0.695, p<0.001). In direct comparison of high-risk groups, SUA again demonstrated superior performance than the prediction models (high-risk SUAAUC 0.668, p = 0.001) in predicting LTLS, approaching that of the combined model (AUC 0.685, p<0.001). In conclusion, SUA alone is comparable and highly predictive for LTLS than other prediction models.
authors.affiliation: Division of Nephrology, Hypertension and Transplantation, North Florida/South Georgia Veterans Health System, Gainesville, Florida, United States of America.
authors.forename: A Ahsan
authors.initials: AA
authors.lastname: Ejaz
authors.affiliation: Division of Nephrology, Hypertension and Transplantation, North Florida/South Georgia Veterans Health System, Gainesville, Florida, United States of America.
authors.forename: Negiin
authors.initials: N
authors.lastname: Pourafshar
authors.affiliation: Division of Nephrology, Hypertension and Transplantation, North Florida/South Georgia Veterans Health System, Gainesville, Florida, United States of America; Nephrology & Hypertension Section, Department of Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, Florida, United States of America.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Mohandas
authors.affiliation: Department of Epidemiology, College of Public Health and Health Professions and the College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Smallwood
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Gainesville, Florida, United States of America.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
authors.affiliation: Division of Hematology and Oncology, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Jack W
authors.initials: JW
authors.lastname: Hsu
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D015275:Tumor Lysis Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014527:Uric Acid / Q000097:blood*
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D014527:Uric Acid