{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T07:53:49Z","timestamp":1774338829035,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T00:00:00Z","timestamp":1694908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Chronic lymphocytic leukemia (CLL) is one of the most common hematologic malignancies, especially among elderlies. Several prognostic scores are available that utilize the characteristics of patients\u2019 blood counts and cytogenetic anomalies\u2014all are features of the disease rather than of the patient. Addressing the route of personalized rather than precise medicine, we refer to the assessment of patients\u2019 status of sarcopenia and frailty. Low alanine aminotransferase (ALT) was already shown to function as a surrogate marker for sarcopenia and frailty. We decided to find a possible correlation between low ALT values and poor prognosis of CLL patients. Patients and Methods: This is a retrospective cohort study of CLL patients treated in a large, tertiary medical center, as outpatients or inpatients. Their frailty status was evaluated in a retrospective manner. We defined patients with ALT below 12 IU\/L as frail and divided our cohort into two groups including a low ALT level group (ALT &lt; 12) and a normal ALT level group (ALT \u2265 12). Results: Overall, our final analysis included 716 CLL patients, of which 161 (22.5%) had ALT levels lower than 12 IU\/L. There was no significant difference in patients\u2019 age between the two groups. Patients with the low ALT had a lower hemoglobin concentration (median 10.8 g\/dL [IQR = 2.7] vs. 12.2 [IQR = 3.1]; p &lt; 0.001) and a higher proportion of patients were classified as Binet C score [48.4% vs. 31.1%]; p &lt; 0.001). Frail CLL patients\u2019 survival was significantly shorter when compared to non-frail patients, in both the univariate [HR = 1.6 [95% confidence interval, CI 1.23, 2.0]; p &lt; 0.01] and multivariate analyses [HR = 1.3 [95% CI 1.0, 1.7]; p = 0.03]. Conclusions: Sarcopenia and frailty assessment, based on blood ALT measurements, could potentially point out differences in CLL patients\u2019 prognoses. Such assessment could serve the purpose of treatment personalization of CLL patients.<\/jats:p>","DOI":"10.3390\/cancers15184606","type":"journal-article","created":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T23:32:27Z","timestamp":1694993547000},"page":"4606","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Low Alanine-Aminotransferase Blood Activity Is Associated with Increased Mortality in Chronic Lymphocytic Leukemia Patients: A Retrospective Cohort Study of 716 Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2179-3963","authenticated-orcid":false,"given":"Tamer","family":"Hellou","sequence":"first","affiliation":[{"name":"Hematology Division, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Ramat Gan 5266202, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Dumanis","sequence":"additional","affiliation":[{"name":"Adelson School of Medicine, Ariel University, Ariel 4070000, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arwa","family":"Badarna","sequence":"additional","affiliation":[{"name":"Sheba Medical Center, School of Medicine, Karazin Kharkiv National University, 61022 Kharkiv, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3851-3245","authenticated-orcid":false,"given":"Gad","family":"Segal","sequence":"additional","affiliation":[{"name":"Education Authority, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Ramat Gan 5266202, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1002\/ajh.25595","article-title":"Chronic lymphocytic leukemia: 2020 update on diagnosis, risk stratification and treatment","volume":"94","author":"Hallek","year":"2019","journal-title":"Am. 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