In a study exploring the predictive power of several laboratory findings in malignant pleural mesothelioma, researchers found that high levels of a liver enzyme called aspartate aminotransferase (AST), and increased numbers of white blood cells called monocytes, predict a poor prognosis.
The study, “Elevated aspartate aminotransferase and monocyte counts predict unfavorable prognosis in patients with malignant pleural mesothelioma,” published in the journal Neoplasma, also identified other factors that could predict how well a mesothelioma patient might fare.
In addition to AST and monocyte counts, the research team at Harbin Medical University Cancer Hospital in China reported that low performance status — a measure of patients’ ability to care for themselves and manage everyday activities — and best supportive care were associated with a poorer prognosis, suggesting that the type of treatment does matter for survival.
The study included 105 patients, including 43 women, whose medical records were reviewed retrospectively. A large number of parameters were considered, including tumor location, blood cell counts, and a variety of laboratory measurements.
The majority, or 78.1 percent, were treated with medical therapy, including single drugs or combinations of chemo-, radio-, immuno-, or targeted therapy. Another 14.3 percent received best supportive care, and only 7.6 percent had surgery in addition to chemotherapy or radiotherapy.
Median survival time in the entire group was 20 months, including two patients who survived for more than 60 months. Looking at survival in the different treatment groups, the study found that those receiving best supportive care lived for a median of 2.3 months. The chemotherapy group survived for a median of 22.5 months, and those also treated with surgery for 29.7 months.
A good performance status, normal levels of AST, and low monocyte counts, likewise, were associated with longer survival.
Researchers found that high AST levels and monocyte counts were, in turn, linked to several other parameters in the patients. Both correlated with the presence of anemia and higher levels of the enzyme alkaline phosphatase ALP.
AST levels were also linked to the levels of the enzymes alanine aminotransferase and lactate dehydrogenase, while monocyte counts were also linked to a range of parameters, including male sex and blood cell counts.