Endothelial factors for prediction of mortality in blood cancer patients with sepsis

Objective. To investigate predictive capability of serum von Willebrand factor (VWF:Ag) and syndecan-1 (SDC-1) in blood cancer patients with sepsis. Material and methods. The study encompassed a cohort of 71 blood cancer patients with sepsis between 2020 and 2022. Disease severity and organ dysfunction were evaluated using the Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), and Sepsis-related Organ Failure Assessment (SOFA) scoring systems. Prognostic value of SDC-1 and VWF:Ag concentrations in predicting mortality was assessed. Results. The mortality rate was 39.4%. Comparative analysis of SDC-1 and VWF:Ag concentrations in patients with different outcomes revealed significantly higher concentrations of SDC-1 (Mann-Whitney U=217.0; p<0.001) and VWF:Ag (Mann-Whitney U=268.5; p<0.001) in dead patients. No significant differences were observed in procalcitonin and C-reactive protein (CRP) concentrations between survivors and non-survivors. Positive correlations were demonstrated between SDC-1 concentrations and SOFA scores (Spearman’s rho=0.338, p=0.004), as well as APACHE II scores (Spearman’s rho=0.346; p=0.003). Similarly, positive correlations were observed between VWF:Ag concentrations and APACHE II scores (Spearman’s rho=0.296; p=0.012), as well as APACHE II scores (Spearman’s rho=0.272, p=0.022). Survival analysis revealed significant differences in outcomes between patients with SDC-1 concentrations greater and less than the median (14 ng/ml) (log-rank χ2=5.77, p=0.016) and VWF:Ag concentrations greater and less than the median (383%) (log-rank χ2=11.74; p=0.0006). Multivariate analysis demonstrated a significant association between SDC-1 (OR=1.052; 95% CI 1.020—1.084; p=0.001) and VWF:Ag (OR=1.005; 95% CI 1.001—1.009; p=0.011) concentrations with mortality. Conclusion. SDC-1 and VWF:Ag concentrations may be potential biomarkers for predicting mortality in blood cancer patients with sepsis.