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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Molecular and Cellular Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1521179

Serum stromal cell-derived factor 1α as a prognostic indicator in elderly patients with acute myeloid leukemia receiving CAG-based chemotherapy

Provisionally accepted
Zhenzhen Wang Zhenzhen Wang 1Jing Yuan Jing Yuan 2*Nan Zhou Nan Zhou 2Jianfeng Zhang Jianfeng Zhang 1*
  • 1 Fourth Hospital of Hebei Medical University, Shijiazhuang, China
  • 2 Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China

The final, formatted version of the article will be published soon.

    Background: Stromal-cell-derived factor 1 (SDF-1) plays a crucial role in hematopoiesis and has been implicated in acute myeloid leukemia (AML) pathogenesis. Understanding its relationship with chemotherapy outcomes could lead to improved therapeutic approaches for elderly AML patients. Methods: This study retrospectively analyzed the medical records of elderly AML patients (n = 187) and compared serum SDF-1α levels with age-matched controls (n = 120). Patients received CAG (cytarabine, aclarubicin, and G‐CSF)-based chemotherapy, and serum SDF-1α levels were assessed using ELISA. Results: Serum SDF-1α levels were significantly elevated in elderly AML patients compared to controls (p < 0.001). Receiver operating characteristic (ROC) analysis confirmed its diagnostic relevance, revealing the area under the ROC curve (AUC) of 0.76. Factors such as age, French-American-British (FAB) classification, Eastern Cooperative Oncology Group (ECOG) performance status, primary AML status, white blood cell count, and bone marrow blast cell ratio, were confirmed to be prognostically relevant. Serum SDF-1α levels were elevated in patients who did not achieve complete remission (NCR) compared to those in complete remission (CR). ROC analysis further highlighted the predictive capability of serum SDF-1α for chemotherapy responsiveness. Independent predictors of treatment failure included age, FAB classification, ECOG status, and serum SDF-1α levels. Following chemotherapy, serum SDF-1α levels decreased in patients in CR but remained unchanged in those in NCR. Higher baseline levels of SDF-1α were associated with shorter overall survival. Conclusions: Elevated serum SDF-1α levels in elderly AML patients are associated with poor chemotherapy response and shorter survival. Baseline serum SDF-1α levels could serve as a prognostic marker for CAG-based treatment outcomes.

    Keywords: Stromal-cell-derived factor 1 alpha (SDF-1α), acute myeloid leukemia (AML), Elderly, CXC chemokine receptor type 4 (CXCR4), chemotherapy response

    Received: 01 Nov 2024; Accepted: 20 Dec 2024.

    Copyright: © 2024 Wang, Yuan, Zhou and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jing Yuan, Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China
    Jianfeng Zhang, Fourth Hospital of Hebei Medical University, Shijiazhuang, China

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