[The Relationship between OPN, NLR and Chemotherapy Efficacy in Patients with Acute Myeloid Leukemia]

To analyze the relationship between osteopontin (OPN), neutrophil/lymphocyte ratio (NLR) and chemotherapy efficacy in patients with acute myeloid leukemia (AML).

The clinical data of AML patients who received cytarabine (Ara-C) + idarubicin (IDA) induction chemotherapy in Nanyang First People's Hospital from March 2021 to February 2023 were retrospectively analyzed through the hospital information system. According to the induction chemotherapy results, the selected patients were divided into chemotherapy effective and ineffective groups. Logistic regression was used to analyze the relationship between OPN, NLR and chemotherapy efficacy in AML patients. Receiver operating characteristic (ROC) curves and decision curves were drawn to analyze the application value of OPN and NLR in predicting chemotherapy efficacy in AML patients.

This study enrolled 103 AML patients, and 30 patients did not achieve complete response (CR) after two rounds of induction chemotherapy and were evaluated as chemotherapy ineffective (29.13%), with chemotherapy effective accounting for 70.87%. The proportion of patients aged≥60 years, with poor prognosis and combined central nervous system infiltration (CNSL) in the chemotherapy ineffective group were higher than those in the chemotherapy effective group, and serum OPN, lactate dehydrogenase (LDH), β₂-microglobulin (β₂-MG), and NLR values were also significantly higher than those in the chemotherapy effective group (all P < 0.01). Logistic regression analysis showed that the ineffective chemotherapy in AML patients was associated with age≥60 years, poor prognosis, increased NLR value, and high expression of serum OPN, LDH, and β₂-MG (all P < 0.05). ROC curve analysis showed that the area under the curve for OPN and NLR alone or in combination to predict the risk of ineffective chemotherapy in AML was 0.787, 0.770, and 0.853, respectively, all of which had certain predictive value. Decision curve analysis showed that age, prognostic risk, NLR, OPN, LDH, and β₂-MG all had certain benefits in predicting the risk of chemotherapy failure in AML patients, and the combined prediction had a higher benefit rate.

The combination of Ara-C and IDA in AML patients has a risk of ineffective induction chemotherapy, which may be related to serum OPN and NLR values. High expression of serum OPN and elevated NLR value may increase the risk of ineffective induction chemotherapy. The combination of serum OPN and NLR can assist in improving the predictive value of Ara-C combined with IDA in AML patients.