EHA Library - The official digital education library of European Hematology Association (EHA)

URIC ACID LEVEL MIGHT BE A PROGNOSTIC INDICATOR FOR SURVIVAL IN PATIENTS WHO UNDERWENT ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION (AHSCT). SINGLE CENTER EXPERIENCE
Author(s):
Neslihan Mandaci Şanli
,
Neslihan Mandaci Şanli
Affiliations:
Hematology and Bone Marrow Transplant Center,Erciyes University School of Medicine,KAYSERİ,Turkey
serdar şıvgın
,
serdar şıvgın
Affiliations:
Hematology and Bone Marrow Transplant Center,Erciyes University School of Medicine,KAYSERİ,Turkey
leylagül kaynar
,
leylagül kaynar
Affiliations:
Hematology and Bone Marrow Transplant Center,Erciyes University School of Medicine,KAYSERİ,Turkey
bülent eser
,
bülent eser
Affiliations:
Hematology and Bone Marrow Transplant Center,Erciyes University School of Medicine,KAYSERİ,Turkey
mustafa çetin
,
mustafa çetin
Affiliations:
Hematology and Bone Marrow Transplant Center,Erciyes University School of Medicine,KAYSERİ,Turkey
ali ünal
ali ünal
Affiliations:
Hematology and Bone Marrow Transplant Center,Erciyes University School of Medicine,KAYSERİ,Turkey
(Abstract release date: 05/18/17) EHA Library. Mandaci Şanli N. 05/18/17; 182884; PB2171
Neslihan Mandaci Şanli
Neslihan Mandaci Şanli
Contributions
PDF Abstract
Abstract

Abstract: PB2171

Type: Publication Only

Background

Uric acid (UA) is an abundant aqueous antioxidant that accounts for almost two thirds of all free-radical-scavenging activity in human serum. It is released from injured cells during conditioning for allogeneic hematopoietic stem cell transplantation (AHSCT).

Aims

The aim of this study was to evaluate the prognostic impact of pre transplantation uric acid levels on survival and mortality in allogeneic HSCT patients.

Methods

We retrospectively analyze 273 patients with hematologic diseases undergoing AHSCT. The patients were categorized as patients with acute leukemia, myelodysplastic syndrome, lymphoma patients and other hematologic disease diagnoses. A serum uric asid concentration 3.4 mg/dl was considered hypouricemia. Pretransplantation uric asid, creatine, total protein and albumin were analyzed. Univariate, multivariate Cox regression models and Kaplan–Meier curves were performed to uric asid, creatine, total protein and albumin associated with disease-free survival (DFS), over all survival (OS), early non relaps mortality (+30 day ) and late non relaps mortality (+100 day).

Results

Pretransplantation low uric acid levels were detected in 57 (%20.8) patients. Low UA levels were significantly associated with DFS (HR: 0.52; p= 0.027) . None of the creatine, total protein and albümin were significantly associated with DFS (HR:0.98; p= 0.98, HR :0.87 p=0.60, HR: 1.15; p= 0.66 ). There was no significant association between UA, creatine, total protein and albümin levels and overall survival (HR: 0.84; p= 0.46, HR: 2.10; p= 0.057, HR :0.88; p= 0.52, HR: 0.78; p= 0.26), early relapse mortality (HR: 1.38; p=0.54, (HR: 2.16; p= 0.29, HR: 0.61; p= 0.25, HR: 0.53; p= 0.13 ) and late non-relapse mortality (HR:0.57; p=0.35, HR: 0.21; p=0.29, HR: 1.04; p= 0.94, HR: 1.07; p= 0.92).

Conclusion
Uric asid is a natural antioxsidant compound. UA reacts with oxygen-derived free radicals and becomes oxidized. Since humans are unable to catabolize UA to the more soluble compound allantoin due to lack of urate oxidase or uricase, the serum UA concentration is higher in humans than almost all other mammals. However, this high UA level in humans has been regarded as being beneficial in the presence of elevated oxidative stress. Our study supports that the uric asid is a antioxidant compound. BecauseDisease-free survival is lower in patients with low uric acid levels before transplantation. This is the first report demonstrating a positive association between UA levels and survival analyses in allogeneic HSCT patients. Our findings are potentially clinically relevant. Confirmation in independent cohorts and further investigations into underlying mechanisms, such as reduced antioxidative capacity in hypouricemia, are warranted. In thecoming years, as a result of increased works on this subject, uric asid may be considered a possible prognostic marker in allogeneic hematopoietic stem cell transplantation.

Session topic: 22. Stem cell transplantation - Clinical

Keyword(s): Survival, Allogeneic hematopoietic stem cell transplant

Abstract: PB2171

Type: Publication Only

Background

Uric acid (UA) is an abundant aqueous antioxidant that accounts for almost two thirds of all free-radical-scavenging activity in human serum. It is released from injured cells during conditioning for allogeneic hematopoietic stem cell transplantation (AHSCT).

Aims

The aim of this study was to evaluate the prognostic impact of pre transplantation uric acid levels on survival and mortality in allogeneic HSCT patients.

Methods

We retrospectively analyze 273 patients with hematologic diseases undergoing AHSCT. The patients were categorized as patients with acute leukemia, myelodysplastic syndrome, lymphoma patients and other hematologic disease diagnoses. A serum uric asid concentration 3.4 mg/dl was considered hypouricemia. Pretransplantation uric asid, creatine, total protein and albumin were analyzed. Univariate, multivariate Cox regression models and Kaplan–Meier curves were performed to uric asid, creatine, total protein and albumin associated with disease-free survival (DFS), over all survival (OS), early non relaps mortality (+30 day ) and late non relaps mortality (+100 day).

Results

Pretransplantation low uric acid levels were detected in 57 (%20.8) patients. Low UA levels were significantly associated with DFS (HR: 0.52; p= 0.027) . None of the creatine, total protein and albümin were significantly associated with DFS (HR:0.98; p= 0.98, HR :0.87 p=0.60, HR: 1.15; p= 0.66 ). There was no significant association between UA, creatine, total protein and albümin levels and overall survival (HR: 0.84; p= 0.46, HR: 2.10; p= 0.057, HR :0.88; p= 0.52, HR: 0.78; p= 0.26), early relapse mortality (HR: 1.38; p=0.54, (HR: 2.16; p= 0.29, HR: 0.61; p= 0.25, HR: 0.53; p= 0.13 ) and late non-relapse mortality (HR:0.57; p=0.35, HR: 0.21; p=0.29, HR: 1.04; p= 0.94, HR: 1.07; p= 0.92).

Conclusion
Uric asid is a natural antioxsidant compound. UA reacts with oxygen-derived free radicals and becomes oxidized. Since humans are unable to catabolize UA to the more soluble compound allantoin due to lack of urate oxidase or uricase, the serum UA concentration is higher in humans than almost all other mammals. However, this high UA level in humans has been regarded as being beneficial in the presence of elevated oxidative stress. Our study supports that the uric asid is a antioxidant compound. BecauseDisease-free survival is lower in patients with low uric acid levels before transplantation. This is the first report demonstrating a positive association between UA levels and survival analyses in allogeneic HSCT patients. Our findings are potentially clinically relevant. Confirmation in independent cohorts and further investigations into underlying mechanisms, such as reduced antioxidative capacity in hypouricemia, are warranted. In thecoming years, as a result of increased works on this subject, uric asid may be considered a possible prognostic marker in allogeneic hematopoietic stem cell transplantation.

Session topic: 22. Stem cell transplantation - Clinical

Keyword(s): Survival, Allogeneic hematopoietic stem cell transplant

Premium Sponsors

What's new at EHA

Browse the open-source material from EHA past Congresses and meetings.

References

EHA Terms & Conditions
2025 ©
European Hematology Association
USER TERMS AND CONDITIONS / PRIVACY POLICY
(Amended according to GDPR)

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies