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Research
Natalia Maximova
Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0934-1875
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Background: Total body irradiation (TBI) is a mandatory step for patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (HSCT). In the past, amylases have been reported to be a possible sign of TBI toxicity. We investigated the relationship between total amylases (TA) and transplant-related outcomes in pediatric recipients.
Methods: We retrospectively analyzed the medical records of all the patients who underwent allogeneic HSCT between January 2000 and November 2019. Inclusion criteria were the following: recipient’s between 2 and 18, diagnosis of ALL, no previous transplantation, and use of TBI-based conditioning. Serum total amylase and pancreatic amylase were evaluated before, during and after transplantation. Cytokines and chemokines assays were retrospectively performed.
Results: 78 patients fulfilled the inclusion criteria. 57 patients were treated with fractionated TBI and 21 with a single dose regimen. Overall survival (OS) was 62.8%. Elevated values of TA were detected in 71 patients (91%). TA were excellent in predicting the OS (AUC = 0.773; 95% CI = 0.66-0.86; P < 0.001). TA values below 374 U/L were correlated with a higher OS. The highest mean TA values (673 U/L) were associated with a high disease-progression mortality rate. TA showed high predictive performance for disease progression-related death (AUC = 0.865; 95% CI = 0.77 – 0.93; P < 0.0001). Elevated TA values were also connected with significantly higher levels of proinflammatory cytokines such as TNF-α, IL-6 and RANTES (P < 0.001).
Conclusions: This study shows that TA is a valuable predictor of post-transplant OS and increased risk of leukemia relapse.
Keywords
total body irradiation, total amylase, proinflammatory cytokines, hematopoietic stem cell transplantation, overall survival, leukemia relapse, pediatric patients
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CURRENT STATUS: Under Review
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Posted 15 Jan, 2021
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Review #1 received
Received 25 Feb, 2021
Reviewer #2 agreed
On 24 Feb, 2021
Reviewers invited
Invitations sent on 21 Feb, 2021
Reviewer #1 agreed
On 21 Feb, 2021
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On 10 Jan, 2021
Editor invited
On 10 Jan, 2021
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On 10 Jan, 2021
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A new preprint design is coming!
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This preprint is under consideration at Journal of Translational Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Natalia Maximova
Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0934-1875
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 15 Jan, 2021
No community comments so far
Review #1 received
Received 25 Feb, 2021
Reviewer #2 agreed
On 24 Feb, 2021
Reviewers invited
Invitations sent on 21 Feb, 2021
Reviewer #1 agreed
On 21 Feb, 2021
Editor assigned
On 10 Jan, 2021
Editor invited
On 10 Jan, 2021
Submission checks complete
On 10 Jan, 2021
First submitted
On 07 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Translational Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Total body irradiation (TBI) is a mandatory step for patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (HSCT). In the past, amylases have been reported to be a possible sign of TBI toxicity. We investigated the relationship between total amylases (TA) and transplant-related outcomes in pediatric recipients.
Methods: We retrospectively analyzed the medical records of all the patients who underwent allogeneic HSCT between January 2000 and November 2019. Inclusion criteria were the following: recipient’s between 2 and 18, diagnosis of ALL, no previous transplantation, and use of TBI-based conditioning. Serum total amylase and pancreatic amylase were evaluated before, during and after transplantation. Cytokines and chemokines assays were retrospectively performed.
Results: 78 patients fulfilled the inclusion criteria. 57 patients were treated with fractionated TBI and 21 with a single dose regimen. Overall survival (OS) was 62.8%. Elevated values of TA were detected in 71 patients (91%). TA were excellent in predicting the OS (AUC = 0.773; 95% CI = 0.66-0.86; P < 0.001). TA values below 374 U/L were correlated with a higher OS. The highest mean TA values (673 U/L) were associated with a high disease-progression mortality rate. TA showed high predictive performance for disease progression-related death (AUC = 0.865; 95% CI = 0.77 – 0.93; P < 0.0001). Elevated TA values were also connected with significantly higher levels of proinflammatory cytokines such as TNF-α, IL-6 and RANTES (P < 0.001).
Conclusions: This study shows that TA is a valuable predictor of post-transplant OS and increased risk of leukemia relapse.
Figure 1
Figure 2
Figure 3
Figure 4
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