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Establishment and evaluation of a prognostic model for sodium overload necrosis in acute myeloid leukemia
1Department of Hematology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Background:
Acute myeloid leukemia (AML) is a highly heterogeneous hematologic malignancy with a poor prognosis. Recent studies have revealed that sodium overload-induced necrosis participates in the pathogenesis of various tumors; however, its role in AML remains unclear. In this study, we developed a risk model based on genes related to sodium overload-induced necrosis to predict survival outcomes in patients with AML.
Methods:
Using The Cancer Genome Atlas (TCGA)-Acute Myeloid Leukemia (LAML) cohort as the training set and the Gene Expression Omnibus (GEO) cohort as the validation set, nine prognostic genes related to sodium overload-induced necrosis were screened to establish a robust risk prediction model, the RiskScore. Patients were stratified into high- and low-risk groups based on their RiskScore. Predictive accuracy was further validated using receiver operating characteristic (ROC) curves. The correlation between the RiskScore and various types of immune cells was further assessed to explore potential associations between the RiskScore and the immune microenvironment.
Results:
Survival analysis revealed significantly better outcomes in the low-risk group than in the high-risk group. Univariate and multivariate Cox regression analyses indicated that the RiskScore was an independent prognostic factor for patients with AML, with area under the ROC curve of 0.838, 0.811, and 0.774 for 1-, 3-, and 5-year survival, respectively, in the TCGA-LAML training set. Immune infiltration analysis indicated that the RiskScore was positively correlated with M2 macrophages and monocytes infiltration but negatively correlated with infiltration of mast cells, suggesting close links between sodium overload-induced necrosis and the immune microenvironment.
Conclusions:
The RiskScore model effectively predicted the prognosis of AML and provided a novel theoretical basis for the management of risk stratification and targeted therapy, highlighting potential therapeutic targets.
