Serum albumin (SA) levels may not only be an independent prognostic factor for patients with acute myeloblastic leukemia (AML), but also a better parameter than body-mass index (BMI) for evaluating nutritional status at diagnosis, according to a study published in Hematological Oncology.

Evidence from previous studies have suggested that patient BMI and nutritional status at the time of diagnosis could be predictive of outcomes in AML. 

For this single-center retrospective study, researchers reviewed the outcomes of 159 patients with AML treated with high-dose cytarabine plus aracytine and anthracycline-based regimens. Investigators collected baseline SA levels and BMI data and evaluated their association with survival outcomes. 

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At diagnosis, 44% and 56% of patients were of normal weight or overweight/obese, respectively, and 30.8% and 69.2% of patients had SA levels less than 30 g/L and 30 g/L or higher, respectively. The median follow-up was 49 months.

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Results showed that there was no significant association between BMI at the 25 kg/mthreshold (P=.54) and overall survival (OS). 

A high SA level at baseline, however, was significantly associated with improved OS; patients with SA level 30 g/L or higher at baseline had a median OS of 35.6 months vs 13.2 months among patients with lower levels (P=.02). Furthermore, the 3-year OS rate was 49% among patients with high SA compared with 29% with hypoalbuminemia (P=.02). 

Similarly, median event-free survival (EFS) was 20.4 months among patients with SA level 30 g/L or higher vs 8.61 months among patients with SA levels less than 30 g/L (P=.003), and the 3-year EFS was 29% and 13% among patients with high vs low SA levels, respectively (P=.003).

The authors concluded that “the value of this prognostic factor should be assessed in prospective studies since it is easy to measure. Protein/albumin supplementation could therefore be considered before initiating or in the same time starting induction therapy in AML patients with hypoalbuminemia, whatever their BMI.”


Filliatre-Clement L, Broseus J, Muller M, et al. Serum albumin or body mass index: which prognostic factor for survival in patients with acute myeloblastic leukaemia? [published online August 13, 2018].Hematol Oncol. doi: 10.1002/hon.2543