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Elastase, one of the fourth most represented neutrophil\u2010specific serine proteases stored in azurophil granules of na\u00efve neutrophils, exerts various actions, including degradation of extracellular matrix and has proinflammatory functions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Plasma was obtained from 111 patients with various hematological malignancies and 42 healthy donors, and plasma elastase levels were measured by ELISA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Reduced circulating levels of neutrophil elastase were found in patients with myelodysplastic syndromes (MDS) and chronic lymphocytic leukemia, while they were increased in acute myeloid leukemia (AML) and non\u2010Hodgkin lymphomas (NHL), with statistically significant AUCs (AML, AUC\u2009=\u20090.7821 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0182; and NHL, AUC\u2009=\u20090.7521 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0008). Moreover, multiple patients with standard\u2010risk genetic features tended to have higher plasma elastase levels compared to healthy controls. Patients were then divided into two groups, using a cut\u2010off of 300\u2009ng\/mL of plasma elastase, and clinical outcomes were compared, showing reduced overall survival and progression\u2010free survival in those subjects with increased plasma elastase levels, as well as shorter time\u2010to\u2010treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings indicate that circulating plasma elastase could be useful to distinguish across diseases in the differential diagnosis of hematological malignancies, and could be used as additional prognostic biomarker of disease progression and responsiveness to therapies.<\/jats:p>\n                  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