The effect of conut nutritional score on prognosis in patients with acute myeloid leukemia

Purpose: Acute myeloid leukemia (AML) is a clonal disease characterized by proliferation and accumulation of myeloid progenitor cells in the bone marrow. The control nutritional status (CONUT) score, based on three indices: serum albumin, total cholesterol, and absolute lymphocyte count, has been closely associated with the prognosis of patients with malignancy. Numerous studies have demonstrated the importance of the CONUT score in hematological malignancies. As a result of the study, it was aimed to evaluate the effect of the conut nutrition index calculated at the time of the first diagnosis of patients with AML on the prognosis. Methods: In this study, we retrospectively analyzed the prognostic effect of conut nutrition score of 93 patients aged 19-85 years who applied to the hematology clinic of Dicle University and had total cholesterol measured at the time of diagnosis. The scoring criteria for the CONUT score are shown as follows: normal-CONUT (0-1), mild-CONUT (2-4), moderate-CONUT (5-8), and severe-CONUT (≥9). Results: In our study, it was determined that 44.1% of the patients were female and 55.9% were male. Although the ages of the patients ranged from 19 to 85 years, the mean age was found to be 49.98 ± 17.03 years. The mean body mass index of the patients was determined as 25.28 ± 4.21 kg/m2. Conut and sConut levels of the patients were evaluated. According to the results obtained; It was determined that 5.4% of the patients had normal, 34.4% mild, 38.7% moderate and 21.5% severe Conut levels. It was determined that 28% of the patients had a low sConut value and 72% a high sConut value. According to the results obtained; The median age of the patients with remission in the 6-month period was 47.5, and the median age of the patients who were refractory was 56. It was found statistically significant that the age of the patients who had remission in the 6-month period was lower than the patients who were in the refractory state (Z=-2.033; p<0.05). The 6-month prognosis of the patients was evaluated according to Conut and sConut levels. According to the results obtained; During the 6-month period, remission was observed in all patients with normal Conut level, 71.9% of mild patients, 61.1% of moderate patients and 20% of severe patients. In the 6-month period, the disease was found to be refractory in 28.1% of patients with mild, 38.9% of patients with moderate and 80% of patients with severe Conut level. A statistically significant difference was found in the prognosis of the patients according to Conut levels in the 6-month period (X2=18.156; p<0.05). As the Conut level of the patients increased in the 6-month period, the rate of observing remission decreased, while the rate of refractory disease increased. Remission was observed in 92.3% of patients with low sConut levels and 44.8% of patients with high sConut levels in the 6-month period. In the 6-month period, 7.7% of the patients with low sConut level and 55.2% of the patients with high sConut level were found to have refractory disease. A statistically significant difference was found in the prognosis of the patients according to their sConut levels in the 6-month period (X2=17.379; p<0.05). It was determined that the rate of observing remission in patients with low sConut level in the 6-month period was higher than the rate of refractory disease. A statistically significant difference was found in the prognosis of the patients according to Conut levels in the 1-year period (X2=15.358; p<0.05). It was determined that as the Conut level of the patients increased in the 1-year period, the rate of observing remission decreased, while the rate of refractory and recurrence of the disease increased. Among the patients with normal Conut level, the 6-month OS rate was 100%, the 1-year OS rate was 100%, and the 3-year OS rate was 80%; 6-month OS rate 78%, 1-year OS 66% and 3-year OS 63% in those with mild Conut level; 6-month OS rate 72%, 1-year OS rate 58% and 3-year OS rate in those with moderate Conut level For those with 44 and severe Conut, the 6-month OS rate was 25% and the 1-year OS rate was 15%. As a result of Kaplan Meier survival analysis; a significant difference was found in terms of survival curves according to the Conut levels of the patients (Log Rank Mantel Cox=38.193; p=0.000). It was determined that as the Conut levels of the patients increased, the survival rates decreased. Among the patients with a low sConut level, the 6-month OS rate was 96%, the 1-year OS rate was 81%, and the 3-year OS rate was 73%; In those with high sConut levels, the 6-month OS rate was 54%, the 1-year OS rate was 43%, and the 3-year OS rate was 31%. As a result of Kaplan Meier survival analysis; A significant difference was found in terms of survival curves according to the sConut levels of the patients (Log Rank Mantel Cox=14.859; p=0.000). It was determined that the survival rate of patients with high sConut level was lower than patients with low sConut level. Conclusion: In conclusion, our study includes important clinical findings as it evaluates the prognosis and average survival with the CONUT score in AML patients. We conclude that in this population, the higher the CONUT score, the worse the nutritional status and may be associated with adverse clinical outcomes. Since the CONUT score is a simple and inexpensive scoring system, we think that it may be useful in clinical practice to determine the prognosis and mean survival in AML patients. Keywords: Acute myeloid leukemia, CONUT, sCONUT