title: High serum concentration of L-kynurenine predicts unfavorable outcomes in patients with acute myeloid leukemia.
abstract: The immunomodulatory effects of indoleamine 2,3-dioxygenase (IDO) are ascribed to its ability to catalyze the breakdown of the L-tryptophan along the L-kynurenine pathway. Because blasts from patients with acute myeloid leukemia (AML) express IDO, the goal of this study was to investigate the role of L-kynurenine as a prognostic marker for AML. We enrolled 48 AML patients. L-kynurenine concentrations were measured by high-performance liquid chromatography. The median serum L-kynurenine level was 1.67 μM. There was no significant difference in the complete remission rate between patients with L-kynurenine < 2.4 (77%) and ≥ 2.4 μM (75%). However, 3-year overall survival (OS) rates were significantly better in patients with low L-kynurenine levels (76%) than in those with high L-kynurenine levels (11%) (p < 0.0001). Furthermore, in intermediate-risk cytogenetics patients, only L-kynurenine was significantly associated with OS (p < 0.005). Multivariate analyses revealed that L-kynurenine and high leukocyte count were independent prognostic factors.
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Mabuchi
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Shibata
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakamura
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Kitagawa
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kanemura
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Naoe
authors.initials: N
authors.lastname: Goto
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: b Department of Informative Clinical Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ito
authors.affiliation: c Human Health Sciences, Graduate School of Medicine and Faculty of Medicine, Kyoto University , Kyoto , Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: c Human Health Sciences, Graduate School of Medicine and Faculty of Medicine, Kyoto University , Kyoto , Japan.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Saito
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
authors.affiliation: a First Department of Internal Medicine , Gifu University Graduate School of Medicine , Gifu , Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tsurumi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D002871:Chromosome Banding; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007737:Kynurenine / Q000097:blood*; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012074:Remission Induction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D007737:Kynurenine
keywords: L-kynurenine; L-tryptophan catabolism; acute myeloid leukemia (AML); immunological tolerance; indoleamine 2,3-dioxygenase; prognostic factor