ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Simple Biomarkers Based on CRP and Albumin Predicts Clinical Outcomes in Adult Patients with T-cell Acute Lymphoblastic Leukaemia
Provisionally accepted
- 1The First Hospital of Jilin University, Changchun, China
- 2Zibo Central Hospital, Zibo, China
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Introduction: Inflammation and malnutrition adversely impact outcomes in patients with various malignancies. Composite indices such as the C-reactive protein/albumin ratio (CAR), the CRP×fibrinogen/albumin ratio (CFA), and the modified Glasgow Prognostic Score (mGPS) integrate these parameters, although their prognostic role in T-cell acute lymphoblastic leukaemia (T-ALL) remains underexplored. Methods: In this single-centre retrospective study, 74 adults with T-ALL were included. CAR, CFA, and mGPS were calculated at diagnosis. Receiver operating characteristic curve analysis revealed the optimal cut-off values for the CAR (0.387) and CFA (0.396). Patients were stratified into low-and high-risk groups. Endpoints included rates of complete remission/complete remission with incomplete haematologic recovery (CR/CRi) at end-of-induction (EOI), minimal residual disease (MRD), overall survival (OS), and progression-free survival (PFS). Results: Patients with low CAR, low CFA, or mGPS0 achieved significantly higher rates of CR/CRi (all p<0.05) and MRD <0.1% (all p<0.05) at EOI. These low-risk groups also exhibited significantly fewer chemotherapy cycles to achieve the first CR/CRi (all p<0.001) and shorter time to achieve MRD negativity (all p<0.001). Survival analysis revealed significantly longer OS and PFS in the low-risk group (all p<0.05). Multivariate analysis revealed high CAR (p=0.004) and MRD positivity ≥0.1% at EOI (p=0.043) as independent predictors of poor OS. Subgroup analysis indicated that allogeneic haematopoietic stem cell transplantation significantly improved survival only in high-risk patients. Conclusion: Pretreatment CAR, CFA, and mGPS are robust, accessible prognostic biomarkers in adults with T-ALL. Their integration into initial risk assessment could help guide personalized treatment strategies, including the identification of high-risk patients who may derive greater benefit from aggressive interventions.
Keywords: Acute lymphocytic leukaemia, albumin, C-Reactive Protein, Fibrinogen, prognosis
Received: 22 Sep 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Li, Wen, Shao and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qiuju Liu
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