Low ADAMTS13 activity may be associated with poor prognosis in patients with acute myeloid leukemia (AML) undergoing bone marrow transplantation, according to research published in Hematology.

Researchers assessed ADAMTS13 activity and other laboratory measures in 46 patients who were scheduled to receive haploidentical allogeneic hematopoietic stem cell transplantation. All patients received the same preconditioning and graft-versus-host disease prophylaxis regimens. Medical records from 1 year after transplant were also collected.

The researchers set a cutoff value for ADAMTS13 activity of 481 ng/mL. Patients with ADAMTS13 activity below this cutoff comprised the low ADAMTS13 group, while patients with ADAMTS13 activity above this cutoff were included in the normal activity group.

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Patients with low ADAMTS13 activity were found to have extended activated partial thromboplastin time (median, 42.9 vs 33.6 seconds) and prothrombin time (20.2 vs 11.9 seconds) as well as increased levels of C-reactive protein (median, 86.2 mg/L vs 24.8 mg/L) and D-dimer (median, 3157 ng/mL vs 587 ng/mL).

Transplant-related complications were more prevalent in patients with lower ADAMTS13 activity, with pulmonary infection, cytomegalovirus infection, thrombotic microangiopathies, and respiratory failure reaching statistical significance (P <.05 for all).

Relapse rates were similar between both patient groups. Mortality due to recurrence, infection, GVHD, or mixed causes was higher in the low ADAMTS13 activity group.

Although the role of ADAMTS13 in AML is still unclear, the researchers suggested that “inflammation may play [a] part in the decrease of ADAMTS13 activity.”

Reference

1.     Liu C, Han M, Zhao L, et al. ADAMTS-13 activity reduction in plasma of acute myeloid leukemia predicts poor prognosis after bone marrow transplantation. 2019;24(1):129-133. doi:10.1080/10245332.2018.1532648