Serum gamma-glutamyl transpeptidase/albumin ratio in patients with acute myeloid leukemia: a new perspective on prognostic assessment

OBJECTIVES: Evaluate the gamma-glutamyl transpeptidase-to-albumin ratio (GAR) as a prognostic biomarker in acute myeloid leukemia (AML). METHODS: We retrospectively analyzed the data of 162 patients with AML. Receiver operating characteristic (ROC) curve analysis determined the optimal cutoff value for GAR. Multivariate analysis was performed to assess the independent prognostic role of GAR for overall survival (OS) and event-free survival (EFS). Subgroup analysis was conducted to explore the impact of GAR in specific patient groups. RESULTS: ROC curve analysis showed an optimal cutoff value of 0.84 for GAR. Multivariate analysis revealed that GAR was an independent prognostic factor for OS and EFS. Subgroup analysis demonstrated that a high GAR was associated with shorter OS and EFS in patients with intermediate-risk stratification, those aged ≥60 years, or those that have not undergone hematopoietic stem cell transplantation. DISCUSSION: GAR reflects nutrition, inflammation, and oxidative stress. This study shows its potential to supplement existing AML risk stratification. Future prospective studies are needed to validate its clinical utility. CONCLUSION: We propose GAR as a prognostic biomarker in AML cases, providing a new perspective for prognostic assessment.