Prognostic value of C-reactive protein, lactase dehydrogenase and anemia in recurrent or refractory aggressive lymphoma.

Abstract

OBJECTIVE:

Prognostic predictors for newly diagnosed malignant lymphoma are well known. However, they have not been compared for patients with recurrent or refractory malignant lymphoma.

METHODS:

We retrospectively analyzed biological prognostic predictors for patients with recurrent or refractory aggressive lymphoma, such as serum levels of C-reactive protein, lactate dehydrogenase, hemoglobin, β2-microglobulin and soluble interleukin-2 receptor before salvage therapy. The primary endpoint was overall survival after salvage treatment. First, univariate and multivariate analyses were performed for each of the parameters, using the log-rank test and Cox regression analysis, respectively. Secondly, we classified the patients into three risk groups on the basis of significant poor predictors.

RESULTS:

Sixty-three patients, including 41 patients with diffuse large B-cell lymphoma, were included in this study. Overall survival was significantly worse in patients with elevated C-reactive protein level (hazard ratio 3.757; P = 0.017), elevated lactate dehydrogenase level (hazard ratio 3.948; P = 0.010) and anemia (hazard ratio 3.925; P = 0.016) by multivariate analysis. We classified patients into two groups based on these three biological parameters. The median overall survival of the high- and low-risk patients was 5.8 and 60.1 months, respectively (log-rank test; P < 0.001). The overall response rate was significantly higher among the low-risk patients than among the high-risk patients (71.4 versus 28.6%, P = 0.005). Those results were similar among all aggressive lymphoma and diffuse large B-cell lymphoma.

CONCLUSIONS:

Elevated C-reactive protein level, elevated lactate dehydrogenase level and anemia before salvage treatment predicted poorer outcomes among patients with recurrent or refractory aggressive lymphoma.

• Authors: Kazuhito Suzuki, Yasuhito Terui, Noriko Nishimura, Yuko Mishima, Sakura Sakajiri, Masahiro Yokoyama, Shunji Takahashi, Naoko Tsuyama, Kengo Takeuchi, Kiyohiko Hatake
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 43 Issue 1 Pg. 37-44 (Jan 2013) ISSN: 1465-3621 [Electronic] England
• PMID: 23166385 (Publication Type: Journal Article)

Chemical References

• C-Reactive Protein
• L-Lactate Dehydrogenase

Topics

• Adult
• Aged
• Anemia (diagnosis, etiology)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• C-Reactive Protein (metabolism)
• Combined Modality Therapy
• Drug Resistance, Neoplasm
• Female
• Follow-Up Studies
• Hematopoietic Stem Cell Transplantation
• Humans
• L-Lactate Dehydrogenase (metabolism)
• Lymphoma, Large B-Cell, Diffuse (metabolism, mortality, therapy)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (metabolism, mortality, therapy)
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Salvage Therapy
• Survival Rate
• Transplantation, Autologous