Value of the serum levels of hypoxia-inducible factor 1α，heme oxygenase-1，and thrombopoietin in predicting the short-term prognosis of adult patients with acute myeloid leukemia

Jin Huanran; Gao Jingjing; Wang Lihong; Liu Yanjie; Zhao Hang

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Value of the serum levels of hypoxia-inducible factor 1α，heme oxygenase-1，and thrombopoietin in predicting the short-term prognosis of adult patients with acute myeloid leukemia

更新时间：2026-06-10

- Value of the serum levels of hypoxia-inducible factor 1α，heme oxygenase-1，and thrombopoietin in predicting the short-term prognosis of adult patients with acute myeloid leukemia
- Journal of Chongqing Medical University Pages: 1-6(2026)
- 作者机构：
  
  1.郑州大学第一附属医院血液内科三病区，郑州 450000
  2.郑州大学第一附属医院康复医学科一病区，郑州 450000
  3.郑州大学第一附属医院呼吸及睡眠科室，郑州 450000
- 作者简介：
- 基金信息：
- DOI：
  CLC： R733.72;R733.71
- Received：20 October 2025，
  
  Revised：2026-01-20，
  
  Accepted：25 February 2026，
  
  Online First：10 June 2026，
- 稿件说明：
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Jin Huanran,Gao Jingjing,Wang Lihong,et al.Value of the serum levels of hypoxia-inducible factor 1α，heme oxygenase-1，and thrombopoietin in predicting the short-term prognosis of adult patients with acute myeloid leukemia[J].Journal of Chongqing Medical University,
DOI：

Jin Huanran,Gao Jingjing,Wang Lihong,et al.Value of the serum levels of hypoxia-inducible factor 1α，heme oxygenase-1，and thrombopoietin in predicting the short-term prognosis of adult patients with acute myeloid leukemia[J].Journal of Chongqing Medical University, DOI：10.13406/j.cnki.cyxb..

摘要

目的

探讨成人急性髓系白血病（acute myeloid leukemia，AML）患者血清缺氧诱导因子-1α（hypoxia inducible factor-1α，HIF-1α）、血红素加氧酶-1（heme oxygenase-1，HO-1）及血小板生成素（thrombopoietin，TPO）水平对短期预后的预测价值。

方法

将郑州大学第一附属医院2020年1月至2022年8月收治的86例AML患者纳入研究（AML组），另选取同期90例健康体检者作为对照组，采用酶联免疫吸附测定（enzyme-linked immunosorbent assay，ELISA）检测AML组和对照组受试者血清HIF-1α、HO-1、TPO水平；根据患者的治疗效果分为完全缓解组（

=52）、部分缓解组（

=14）、未缓解组（

=20）；随访患者预后并分为生存组（

=63）和死亡组（

=23），采用多因素Cox回归分析影响AML患者死亡的因素；采用受试者工作特征（receiver operating characteristic curve，ROC）曲线分析血清HIF-1α、HO-1、TPO对AML患者死亡的预测价值。

结果

AML组较对照组血清HIF-1α［（66.75±10.20 ） pg/mL vs.（41.96±5.29） pg/mL］、TPO［（546.42±80.27） pg/mL vs.（297.66±31.62） pg/mL］水平升高，HO-1［（56.98±6.79） ng/mL vs.（74.24±8.55） ng/mL］水平降低（

0.05）；完全缓解组、部分缓解组、未缓解组患者血清HIF-1α、TPO水平逐渐升高，HO-1水平逐渐降低（

0.05）；与生存组相比，死亡组骨髓原始细胞/幼稚细胞比例、中/高风险能级比例、法美英白血病分型（French-American-British classification，FAB）M4/M5型比例、未缓解患者比例以及血清HIF-1α［（76.25±8.41） pg/mL vs. （63.28±7.11） pg/mL］、TPO［（622.13±62.44） pg/mL vs.（518.78±58.65） pg/mL］水平升高，HO-1［（48.24±6.15）ng/mL vs.（60.17±7.02）ng/mL］水平降低（

0.05）；HIF-1α（

=2.115，95%CI=1.382~3.236）、TPO（

=2.156，95%CI=1.099~4.231）是AML患者死亡的危险因素，HO-1（

=0.521，95%CI=0.330~0.823）是保护因素（

0.05）；血清HIF-1α、HO-1、TPO及联合预测患者死亡的曲线下面积（area under the curve，AUC）分别为0.893（95%CI=0.808~0.949）、0.822（95%CI=0.724~0.896）、0.870（95%CI=0.780~0.933）、0.985（95%CI=0.931~0.998），三者联合检测的AUC优于单独检测（

=2.453、3.406、2.189，

0.05）。

结论

AML患者血清HIF-1α、TPO水平升高，HO-1水平降低，三者对患者短期预后具有预测价值。

Abstract

Objective

To investigate the value of the serum levels of hypoxia-inducible factor 1α（HIF-1α），heme oxygenase-1（HO-1），and thrombopoietin（TPO） in predicting the short-term prognosis of adult patients with acute myeloid leukemia（AML）.

Methods

A total of 86 AML patients who were hospitalized in The First Affiliated Hospital of Zhengzhou University from January 2020 to August 2022 were enrolled as AML group，and 90 healthy subjects who underwent physical examination during the same period of time were enrolled as control group. ELISA was used to measure the serum levels of HIF-1α，HO-1，and TPO in both groups. According to the treatment outcome of patients，they were divided into complete remission group with 52 patients，partial remission group with 14 patients，and non-remission group with 20 patients； according to the prognosis of patients during follow-up，they were divided into survival group with 63 patients and death group with 23 patients. A multivariate

Cox

regression analysis was used to identify the influencing factors for death in AML patients，and the receiver operating characteristic （ROC） curve was used to analyze the value of serum HIF-1α，HO-1，and TPO in predicting death of AML patients.

Results

Compared with the control group，the AML group had significant increases in the serum levels of HIF-1α （66.75±10.20 pg/mL vs. 41.96±5.29 pg/mL，

0.05） and TPO （546.42±80.27 pg/mL vs. 297.66±31.62 pg/mL，

0.05） and a significant reduction in the serum level of HO-1 （56.98±6.79 ng/mL vs. 74.24±8.55 ng/mL，

0.05）. The serum levels of HIF-1α and TPO gradually increased in the complete remission group， partial remission group， and non-remission group， while the level of HO-1 gradually decreased（

0.05）. Compared with the survival group，the death group had a significantly higher level of bone marrow blasts/juvenile cells，a significantly higher proportion of patients with medium/high risk levels，a significantly higher proportion of patients with M4/M5 leukemia based on the French-American-British classification system，and a significantly higher proportion of patients without remission，as well as significant increases in the serum leve

ls of HIF-1α（76.25±8.41 pg/mL vs. 63.28±7.11 pg/mL，

0.05） and TPO （622.13±62.44 pg/mL vs. 518.78±58.65 pg/mL，

0.05） and a significant reduction in the serum level of HO-1（48.24±6.15 ng/mL vs. 60.17±7.02 ng/mL，

0.05）. HIF-1α（hazard ratio［

］=2.115，95%CI=1.382-3.236，

0.05） and TPO（

=2.156，95%CI=1.099-4.231，

0.05） were risk factors for death in AML patients，while HO-1（

=0.521，95%CI=0.330-0.823，

0.05） was a protective factor against death. Serum HIF-1α，HO-1，and TPO alone or in combination had an area under the ROC curve （AUC） of 0.893 （95%CI=0.808-0.949），0.822 （95%CI=0.724-0.896），0.870（95%CI=0.780-0.933），and 0.985 （95%CI=0.931-0.998），respectively，in predicting death，and the combination of these three indicators had a better AUC than each indicator alone（

=2.453，3.406，2.189，

0.05）.

Conclusion

There are increases in the serum levels of HIF-1α and TPO and a reduction in the serum level of HO-1 in patients with AML，and all three indicators have a certain value in predicting the short-term prognosis of patients.

关键词

Keywords

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