Role of Uric Acid Levels as a Prognostic Indicator in Allogeneic Hematopoietic Stem Cell Transplantation: Insights from a Single-Center Study

Neslihan Mandacı Şanlı; Muzaffer Keklik; Ali Ünal

doi:10.7197/cmj.1428410

TR EN

Allojenik Hematopoetik Kök Hücre Nakli’ nde Ürik Asit Seviyesinin Prognostik Bir Belirteç Olarak Rolü: Tek Merkez Deneyimi

Öz

Ürik asit (UA) suda çözünebilen zengin bir antioksidan olarak görevi görür ve insan serumundaki toplam serbest radikal süpürücü aktivitenin yaklaşık üçte ikisine katkıda bulunur. Allojeneik hematopoetik kök hücre nakli (allo-HKHN) için hazırlık sırasında hasarlı hücrelerden atılır. Bu çalışmada, allo-HKHN hastalarında nakil öncesi ürik asit düzeylerinin sağkalım ve mortaliteyi nasıl etkilediği değerlendirilmiştir. Hematolojik hastalığı olan ve allo-HKHN yapılan 267 hastanın retrospektif analizinde, ürik asit düzeyleri allo-HKHN gününde (0. gün) belgelenmiştir. Hastalar nakil öncesi ürik asit düzeylerine göre iki gruba ayrılmıştır: 4,4 mg/dL veya altında olanlar ve 4,4 mg/dL'nin üzerinde olanlar. Bunların 153 'ü (%57,3) erkek, 114' ü (%42,7) kadındı ve ortanca yaşları 31'di (13 ile 66 arasında değişiyordu). Serum ürik asit düzeyleri 4,4 mg/dL veya altında olanlar, 4,4 mg/dL'yi aşanlara kıyasla belirgin şekilde daha kötü genel sağkalım (OS) ve hastalıksız sağkalım (DFS) sergilemiştir (sırasıyla p=0,032 ve p=0,045). Bulgularımız, allo-HKHN hastalarında düşük pretransplant serum ürik asit düzeyleri ile azalmış sağkalım oranları arasında bir ilişki olduğunu göstermektedir. Hipoürisemide bozulmuş antioksidatif kapasite gibi potansiyel mekanizmaların daha fazla araştırılması, ürik asidin allo-HKHN' nde umut verici bir prognostik belirteç olmasını sağlayabilir.

Anahtar Kelimeler

Role of Uric Acid Levels as a Prognostic Indicator in Allogeneic Hematopoietic Stem Cell Transplantation: Insights from a Single-Center Study

Abstract

Uric acid (UA) acts as a richly available water-soluble antioxidant, contributing to approximately two-thirds of the overall free-radical-scavenging activity in human serum. It is discharged from damaged cells during the preparation for allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study assessed how pretransplantation uric acid levels influence survival and mortality in allo-HSCT patients. In a retrospective analysis of 267 patients with hematologic diseases who underwent allo-HSCT, uric acid levels were documented on the day of allo-HSCT (day 0). Patients were divided into two cohorts based on their pretransplant uric acid levels: those at or below 4.4 mg/dL and those above 4.4 mg/dL. Among them, 153 (57.3%) were male, and 114 (42.7%) were female, with a median age of 31 years (ranging from 13 to 66). Those with serum uric acid levels of 4.4 mg/dL or lower exhibited notably poorer overall survival (OS) and disease-free survival (DFS) compared to those surpassing 4.4 mg/dL (p=0.032 and p=0.045, respectively). Our findings indicate an interrelation between low pretransplant serum uric acid levels and reduced survival rates in allo-HSCT patients. Further exploration into potential mechanisms, such as compromised antioxidative capacity in hypouricemia, may establish uric acid as a promising prognostic marker in allo-HSCT.

Keywords

References

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Details

Primary Language

English

Subjects

Medical Education

Journal Section

Research Article

Authors

Neslihan Mandacı Şanlı ^*
0000-0002-6298-9884
Türkiye

Muzaffer Keklik
0000-0002-6426-5249
Türkiye

Ali Ünal
0000-0001-7011-3412
Türkiye

Publication Date

June 29, 2024

Submission Date

January 30, 2024

Acceptance Date

June 9, 2024

Published in Issue

Year 2024 Volume: 46 Number: 2

DOI

https://doi.org/10.7197/cmj.1428410

IZ

https://izlik.org/JA48LZ74PS

Cite

RIS / Bibtex

AMA

1.Mandacı Şanlı N, Keklik M, Ünal A. Role of Uric Acid Levels as a Prognostic Indicator in Allogeneic Hematopoietic Stem Cell Transplantation: Insights from a Single-Center Study. CMJ. 2024;46(2):121-128. doi:10.7197/cmj.1428410

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