The prognostic value of plasma fibrinogen level in patients with acute myeloid leukemia: a systematic review and meta-analysis

Abstract

Increasing evidence has revealed that plasma fibrinogen levels may serve as prognostic indicators in patients with acute myeloid leukemia (AML), yet the exact association is still elusive. We conducted a systematic review and meta-analysis of all available studies concerning the relationship between plasma fibrinogen level and survival in AML patients. The pooled hazard ratio (HR) and 95% confidence intervals (CIs) for overall survival (OS) were calculated to evaluate the effect. A random-effect model was applied and the robustness of the pooled results was confirmed by subgroup and sensitivity analysis. A total of 9 studies were eligible to assess the association between plasma fibrinogen level and prognosis in AML. Among these investigations above, 5 studies adopted OS as their outcome indicator and were selected for the final meta-analysis. The pooled result suggested that plasma fibrinogen level was significantly relevant to increased mortality risk in AML patients (HR = 1.21, 95% CI: 1.01–1.44, p = .000, I²=85.4%). In conclusion, high plasma fibrinogen level may independently predict worse OS in patients with AML.

Keywords:

• Fibrinogen
• acute myeloid leukemia
• acute promyelocytic leukemia
• prognosis

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Ziayn Zhang, Rui Zhang and Wenjing Miao. The first draft of the manuscript was written by Ziayn Zhang, Jiaqian Qi and Kun Fang and Changgeng Ruan, Depei Wu and Yue Han commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

This work was supported by National Natural Science Foundation of China (81873432 and 81670132), grants from the Jiangsu Province of China (BE2016665, SBE2016740635 and ZDRCA2016047), The Natural Science Foundation of the Jiangsu Higher Education Institution of China (18KJA320006), and the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).