{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:46:18Z","timestamp":1792788378533,"version":"4.5.0"},"update-to":[{"DOI":"10.12688\/f1000research.183970.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000}}],"reference-count":33,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Clinical Research Unit of National Cancer Center \u2013 Dharmais Cancer Hospital","award":["DP.04.03\/D.XII.2.3\/163\/2026"],"award-info":[{"award-number":["DP.04.03\/D.XII.2.3\/163\/2026"]}],"id":[{"id":"https:\/\/ror.org\/04039yq48","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Treatment response in acute myeloid leukemia (AML) is influenced by multiple biological and molecular mechanisms. High-mobility group box 1 (HMGB-1) is involved in inflammation, autophagy, apoptosis, and immunogenic cell death. This study evaluated associations of baseline circulating miR-181a-3p, miR-181b-5p, ATM, ATR, and HMGB-1 with successful induction response in adults with newly diagnosed AML. Methods This prospective cohort study was conducted at two referral hospitals in Jakarta, Indonesia. Adults with newly diagnosed AML receiving standard D3A7 induction chemotherapy were enrolled consecutively. Baseline miR-181a-3p and miR-181b-5p were quantified using digital polymerase chain reaction, whereas ATM, ATR, and HMGB-1 were measured using enzyme-linked immunosorbent assays before chemotherapy. Successful induction response was assessed by clinical and bone marrow evaluation after induction. Receiver operating characteristic analysis determined an exploratory HMGB-1 cut-off. Associations were evaluated using relative risks (RRs) with 95% confidence intervals (CIs). Results Among 102 patients initiating induction chemotherapy, 25 died during induction or early post-induction care. The biomarker-evaluable cohort comprised 71 patients, of whom 40 (56.3%) achieved a successful response. Baseline miR-181a-3p, miR-181b-5p, ATM, and ATR were not significantly associated with response. HMGB-1 yielded an area under the curve of 0.615 (95% CI, 0.480\u20130.749). The exploratory cut-off was 28.59\u00a0pg\/mL, with 65.0% sensitivity and 61.3% specificity. Low HMGB-1 was associated with a lower probability of successful response (RR, 0.620; 95% CI, 0.394\u20130.975; p\u00a0=\u00a00.038). In the final clinical-biomolecular model, high HMGB-1 remained associated with successful response after adjustment for platelet count and ATR (adjusted RR, 1.666; 95% CI, 1.092\u20132.541; p\u00a0=\u00a00.018). Conclusion Low baseline circulating HMGB-1 was associated with a lower probability of successful induction response in the biomarker-evaluable adult AML cohort. Given its modest discriminatory performance and internally derived cut-off, HMGB-1 should be considered an exploratory complementary biomarker requiring external validation and serial evaluation.<\/ns3:p>","DOI":"10.12688\/f1000research.183970.2","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T10:24:06Z","timestamp":1787048646000},"page":"1143","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline Extracellular HMGB-1 Levels Associated with Induction Chemotherapy Response in Adult Acute Myeloid Leukemia"],"prefix":"10.12688","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1151-571X","authenticated-orcid":false,"given":"Resti","family":"Mulya Sari","sequence":"first","affiliation":[{"name":"Division of Hematology and Medical Oncology Jakarta Dharmais Cancer 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Jakarta Faculty of Medicine, Indonesia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6872-8802","authenticated-orcid":false,"given":"Ikhwan","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Division of Hematology and Medical Oncology Jakarta Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Indonesia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noorwati","family":"Sutandyo","sequence":"additional","affiliation":[{"name":"Division of Hematology and Medical Oncology Jakarta Dharmais Cancer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"ref2","doi-asserted-by":"publisher","first-page":"495","DOI":"10.12688\/f1000research.110320.1","article-title":"Association of leukocyte nadir with complete remission in Indonesian acute myeloid leukemia patients undergoing 7+3 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.207777.r512299, Harsh Goel, All India Institute of Medical Sciences, New Delhi, 02 Sep 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/15-1143\/v2#referee-response-512299","order":0,"name":"referee-response-512299","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.207777.r512300, Deniz Ozmen, Istanbul University Cerrahpa\u015fa, Istanbul, 28 Aug 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/15-1143\/v2#referee-response-512300","order":1,"name":"referee-response-512300","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This study was supported by a research grant from the Clinical Research Unit (CRU), National Cancer Center Dharmais Cancer Hospital Research Centre, Jakarta, Indonesia (Grant Notification No. DP.04.03\/D.XII.2.3\/163\/2026).\r\n\r\nThis manuscript represents a secondary analysis derived from a larger prospective research project entitled \u201cPredictors of Treatment Success in Patients with Acute Myeloblastic Leukemia Receiving Induction Chemotherapy: An Analysis of CD7 Cell Surface Antigen Expression, miRNA 181a-3p, miRNA 181b-5p, ATM Protein, ATR Protein, and HMGB-1 Protein\u201d, which was funded by the Clinical Research Unit.\r\n\r\nThe funder had no role in the study design, data collection, data analysis, interpretation of results, manuscript preparation, or the decision to publish. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}