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- W4387424077 abstract "Several recent studies have demonstrated that urinary levels of liver-type fatty acid-binding protein (L-FABP) can be used to stratify the prognosis of cardiac disease, cardiac intensive care unit admission, cirrhosis, and coronavirus disease 2019. Our initial prospective study revealed that urinary L-FABP (uL-FABP) was associated with a high probability of acute kidney injury after stem cell transplantation (SCT). However, the relevance of elevated uL-FABP to the prognosis of patients receiving SCT remains to be determined. We aimed to investigate whether uL-FABP levels can be used to stratify patient prognosis after SCT. To achieve this aim, we conducted a new long-term follow-up study using data from patients enrolled in our preceding prospective cohort study. Patients were classified into high and low uL-FABP groups based on levels measured at baseline (i.e., before initiating the conditioning regimen), using an uL-FABP cutoff of 8.4 μg/gCr, which was determined based on data from healthy adults. uL-FABP levels were also measured on days 0, 7, and 14 after SCT. Cox proportional hazard regression was used to examine the effects of each factor on survival outcomes, and Fine-Gray regression was used in the presence of competing risks. Multivariate analysis incorporating confounders was then performed for factors with P values <0.1 in the univariate analysis. In total, 20 of 84 patients (23.8%), 57 of 84 patients (67.9%), 34 of 49 patients (69.4%), and 34 of 46 patients (73.9%) were classified into the high uL-FABP group at baseline, on days 0, 7, and 14, respectively. The 5-year overall survival (OS) rates were 23.9% in the high uL-FABP group and 68.9% in the low uL-FABP group. The multivariate analysis identified a high uL-FABP level at baseline as a significant prognostic factor for poor OS (hazard ratio [HR]: 3.54, P = 0.002). The 5-year cumulative incidence rates for non-relapse mortality (NRM) were 50.0% in the high uL-FABP group and 19.9% in the low uL-FABP group. In the multivariate analysis, high uL-FABP at baseline was a significant prognostic factor for NRM (HR: 3.37, P = 0.01). uL-FABP levels did not significantly stratify the cumulative incidence of relapse (HR: 2.13, P = 0.11). uL-FABP levels on days 0, 7, and 14 were not significant survival predictors. High uL-FABP levels before the conditioning regimen significantly influence OS and NRM following SCT, whereas high uL-FABP levels at any point after the conditioning regimen do not. Our results show that measuring uL-FABP levels at baseline may be a simple way to predict survival in patients receiving SCT." @default.
- W4387424077 created "2023-10-08" @default.
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- W4387424077 date "2023-10-01" @default.
- W4387424077 modified "2023-10-11" @default.
- W4387424077 title "Elevation of urinary liver-type fatty acid-binding protein is a harbinger of poor patient prognosis after allogeneic stem cell transplantation" @default.
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- W4387424077 doi "https://doi.org/10.1016/j.jtct.2023.10.003" @default.
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