Patients who were admitted to the University of Fukui Hospital between January 2005 and May 2011 were considered for this study. The S-UA levels were evaluated in association with other parameters and, ultimately, with the prognosis of the disease. The present retrospective study focused on the S-UA levels in patients who were newly-diagnosed with AML and received remission induction chemotherapy. Based on the rapidly proliferating nature of AML, S-UA may be a candidate marker of the aggressiveness of the disease, and thus may be a predictor of prognosis. However, more versatile markers may be more cost-effective and easier to implement in the clinic. Multiparameter flow cytometry may also be useful in detecting minimal residual disease. The detection of minimal residual disease using fusion genes, such as PML-RARA, RUNX1-RUNX1T1, and CBFB-MYH11, and the less specific WT1 may predict for disease relapse. Karyotypic and genetic analyses are most important, because they are closely associated with leukemogenesis. Parameters that can predict the prognosis of AML have been widely investigated ( 8- 11).
Thus, it is important to predict the therapeutic outcome, which will then allow the individualization of the treatment modality. However, the remission is not durable, and long-term survivors account for only 40% of young adult patients with AML. The standard induction chemotherapy regimen achieves complete remission (CR) rates of over 70% in young adult patients with AML ( 5- 7). Because purine nucleic acids are subsequently catabolized to uric acid (UA), the serum UA (S-UA) concentration reflects the breakdown of cancer cells, and is a marker of increased cellular turnover ( 1- 4).Īcute myeloid leukemia (AML) is a cancer of myeloid cells, characterized by the rapid proliferation of leukemic blasts that accumulate in the bone marrow and infiltrate the entire body. Cell lysis leads to the release of intracellular contents, which include electrolytes, proteins, and nucleic acids into the bloodstream ( 1- 3). Thus, the S-UA level may predict the prognosis of AML, and is a versatile and cost-effective test for such a purpose.Ī high rate of proliferation and a high tumor burden cause the rapid lysis of cancer cells ( 1- 3). S-UA levels less than, or equal to the median (5.0 mg/dl) were significantly associated with better prognoses, compared with S-UA levels greater than 5.0 mg/dl.
The S-UA levels in the patients who achieved complete remission were slightly lower than those in those who did not. The S-UA levels did not correlate with peripheral lactate dehydrogenase, peripheral white blood cell counts, or peripheral blast counts, and were not proportional to bone marrow blast counts or marrow cellularity. The median S-UA level at diagnosis was 5.0 mg/dl (range 2-13.8 mg/dl). Fifty-six patients with AML admitted to our Institution were evaluated retrospectively.
S-UA levels were examined for association with clinical outcomes in patients with acute myeloid leukemia (AML). Uric acid in serum (S-UA) is produced by the breakdown of the cellular nucleic acids of leukemia cells, and may be a marker of disease aggressiveness.