Prognostic Value of CAR, AFR and Ferritin in Non-M3 AML

The Prognostic Significance of C-Reactive Protein to Albumin Ratio, Albumin to Fibrinogen Ratio, and Serum Ferritin Level in Newly Diagnosed De Novo Non-M3 Acute Myeloid Leukemia Patients

This prospective cohort study aims to evaluate the prognostic significance of the C-reactive protein-to-albumin ratio (CAR), albumin-to-fibrinogen ratio (AFR), and serum ferritin level in newly diagnosed de novo non-M3 acute myeloid leukemia patients at Assiut University Hospitals.

Acute myeloid leukemia (AML) is an aggressive hematological malignancy with poor clinical outcomes. Inflammatory and nutritional biomarkers such as the C-reactive protein-to-albumin ratio (CAR), albumin-to-fibrinogen ratio (AFR), and serum ferritin have shown potential prognostic value in various malignancies.

This prospective single-center cohort study will include newly diagnosed de novo non-M3 AML patients aged 18 to 65 years. Baseline laboratory parameters including CRP, albumin, fibrinogen, and ferritin will be measured before induction chemotherapy. Patients will be followed for overall survival, event-free survival, and response to induction therapy. The study will assess the association of CAR, AFR, and serum ferritin with clinical outcomes.

Inclusion Criteria:

• Age 18 to 65 years

  • Newly diagnosed de novo non-M3 acute myeloid leukemia
  • Both sexes
  • Willingness to provide informed consent

Exclusion Criteria:

• - Patient refusal
• Significant cardiac, hepatic, or renal disease
• Diabetes mellitus with polyneuropathy
• Severe organ dysfunction (modified Marshall score ≥ 2)
• History of MDS transformed to AML
• Previous blood transfusions
• Relapsed AML
• Previous exposure to chemotherapy or radiotherapy